Characteristics and risk factors of healthcare-associated infection in pa-tients receiving veno-venous extracorporeal membrane oxygenation treat-ment
Objective To analyze the characteristics and risk factors of healthcare-associated infection(HAI)in patients receiving veno-venous extracorporeal membrane oxygenation(V-V ECMO)treatment.Methods Clinical data of 141 patients who received V-V ECMO treatment in the intensive care unit(ICU)of a tertiary first-class hos-pital in Qingdao from January 2019 to November 2023 were collected.Patients were divided into the infection group and non-infection group based on whether HAI occurred.Characteristics of HAI were analyzed,risk factors were analyzed by univariate and multivariate logistic regression analyses.Results Among 141 V-V ECMO patients,inci-dence of HAI was 37.59％(n=53).A total of 81 strains of pathogens were isolated from patients in the infection group,Gram-negative bacteria accounted for 56.79％(n=46),mainly Acinetobacter baumannii,which was up to 28.39％(carbapenem-resistant Acinetobacter baurnannii[CRAB]accounted for 16.05％).The main type of HAI in V-V ECMO patients was pulmonary infection alone(54.72％),followed by bloodstream infection alone(20.75％),multi-site infection accounted for 22.64％.Univariate analysis result showed that compared with the non-infection group,there were statistically significant differences in the history of immunosuppressive agents use,ICU transfer history,surgical history,fiberbronchoscopy,renal replacement therapy,duration of ICU stay,duration of tracheal intubation and/or tracheotomy,duration of urinary catheterization,duration of gastric tube placement,duration of central venous catheterization,duration of antimicrobial use,and duration of V-V ECMO support(all P＜0.05).Multivariate logistic regression analysis result showed that ICU transfer history and fiberbronchoscopy were inde-pendent risk factors for HAI in V-V ECMO patients(OR=6.850,4.643,respectively,both P＜0.05).Conclusion Hospitals should take effective prevention and control measures based on the characteristics and related risk factors of HAI in patients receiving V-V ECMO treatment to reduce the occurrence of HAI.
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