Incidence of candidaemia in prolonged venovenous extracorporeal membrane oxygenation. (January 2022)

• Record Type: Journal Article
• Authors: Monk, E.J.M.; Rautemaa-Richardson, R.; Felton, T.; Montalti, A.; Parkes, M.; Templeton, R.; Ashworth, A.; Garcia, M.; Barker, J.; Thomas, S.
• Is Part Of: Journal of hospital infection. Volume 119(2022)
• Page Start: 49
• Page End: 53
• Publication Date: 2022-01
• Subjects: Candida -- ECMO -- Intensive care -- Nosocomial -- Yeast; Cross infection -- Periodicals; Cross infection -- Prevention -- Periodicals; Nosocomial infections -- Periodicals; Nosocomial infections -- Prevention -- Periodicals; Cross Infection -- Periodicals; Cross Infection -- prevention & control -- Periodicals; Infection Control -- Periodicals; Electronic journals; 614.44
• DOI: 10.1016/j.jhin.2021.09.014
• Languages: English
• ISSNs: 0195-6701

Abstract

Summary: This single-centre retrospective study reports the dynamics of the incidence of candida bloodstream infection (CBSI) in 145 patients receiving venovenous extracorporeal membrane oxygenation (ECMO) for respiratory support between January 2014 and December 2018. The incidence rate and odds ratio (OR) of CBSI were calculated, stratified by week of ECMO exposure. Weekly incidence increased throughout the ECMO run, with an increasing trend in OR ( P =0.005), and a window of continued risk after decannulation was observed. Of the 13 patients who developed CBSI, five (38%) received empirical micafungin treatment before positive culture due to clinical suspicion. There is a need for prospective studies aiming to improve ECMO diagnostic stewardship practices and discourage unnecessary antifungal prophylaxis or empiric management.