title: Nosocomial blood stream infections in patients treated with venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome.
abstract: BACKGROUND
  The incidence of complication rates in patients treated with venovenous extracorporeal membrane oxygenation (VV ECMO) remains substantial and impacts the results of any future trial dealing with ECMO efficacy. Of these complications blood stream infections (BSI) are less well studied. Our objective was to report influence of BSI in ARDS patients treated with VV ECMO.
  
  
  METHODS
  One-hundred adult patients with ARDS treated with VV ECMO at the tertiary care hospital in Zagreb, Croatia between the October of 2009 and the June of 2016 were prospectively included in the study.
  
  
  RESULTS
  In 35% of patients an episode of the nosocomial BSI during VV ECMO treatment was detected. ECMO duration of more than 250 hours and significant bleeding episode independently increase the possibility of acquiring BSI during an ECMO run (odds ratio 3.189, 95% confidence limits 1.108-9.180 and odds ratio 3.378, 95% confidence limits 1.055-10.869 respectively). BSI occurrence had no effect on mortality.
  
  
  CONCLUSIONS
  Our study found that BSI incidence increases with the duration of an ECMO run and bleeding complications with no effect on hospital mortality. Further studies of BSI in this risk group should address the problem of rapid diagnosis and appropriate antimicrobial therapy in an era of growing multiresistance.
authors.affiliation: Unit of Infectious Diseases, School of Medicine, University of Zagreb, Zagreb, Croatia - mkutlesa@bfm.hr.|Department of Intensive Care Medicine and Neuroinfectology, University Hospital for Infectious Diseases &quot;Dr. Fran Mihaljević&quot;, Zagreb, Croatia - mkutlesa@bfm.hr.
authors.forename: Marko
authors.initials: M
authors.lastname: Kutleša
authors.affiliation: Unit of Infectious Diseases, School of Medicine, University of Zagreb, Zagreb, Croatia.|Department of Intensive Care Medicine and Neuroinfectology, University Hospital for Infectious Diseases &quot;Dr. Fran Mihaljević&quot;, Zagreb, Croatia.
authors.forename: Marija
authors.initials: M
authors.lastname: Santini
authors.affiliation: Department of Intensive Care Medicine and Neuroinfectology, University Hospital for Infectious Diseases &quot;Dr. Fran Mihaljević&quot;, Zagreb, Croatia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Krajinović
authors.affiliation: Department of Intensive Care Medicine and Neuroinfectology, University Hospital for Infectious Diseases &quot;Dr. Fran Mihaljević&quot;, Zagreb, Croatia.
authors.forename: Neven
authors.initials: N
authors.lastname: Papić
authors.affiliation: Department of Intensive Care Medicine and Neuroinfectology, University Hospital for Infectious Diseases &quot;Dr. Fran Mihaljević&quot;, Zagreb, Croatia.
authors.forename: Anđa
authors.initials: A
authors.lastname: Novokmet
authors.affiliation: Department of Intensive Care Medicine and Neuroinfectology, University Hospital for Infectious Diseases &quot;Dr. Fran Mihaljević&quot;, Zagreb, Croatia.
authors.forename: Renata
authors.initials: R
authors.lastname: Josipović Mraović
authors.affiliation: Unit of Infectious Diseases, School of Medicine, University of Zagreb, Zagreb, Croatia.|Department of Intensive Care Medicine and Neuroinfectology, University Hospital for Infectious Diseases &quot;Dr. Fran Mihaljević&quot;, Zagreb, Croatia.
authors.forename: Bruno
authors.initials: B
authors.lastname: Baršić
mesh_terms: D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology*; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology*; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012128:Respiratory Distress Syndrome / Q000628:therapy*; D012307:Risk Factors; D014680:Veins