Mornese Pinna, SimoneSousa Casasnovas, IagoOlmedo, MaríaMachado, MarinaJuàrez Fernández, MiriamDevesa Cordero, CarolinaGalar, AliciaÁlvarez Uría, AnaFernández Avilés, FranciscoGarcía Carreño, JorgeMartínez-Sellés D Oliveira Soares, ManuelDe Rosa, Francesco GiuseppeCorcione, SilviaBouza Santiago, EmilioMuñoz García, Patricia CarmenValerio Minero, Maricela2024-06-112024-06-112023-04-20Mornese Pinna S, Sousa Casasnovas I, Olmedo M, Machado M, Juàrez Fernández M, Devesa-Cordero C, et al. Nosocomial Infections in Adult Patients Supported by Extracorporeal Membrane Oxygenation in a Cardiac Intensive Care Unit. Microorganisms. 2023;11(4):107910.3390/microorganisms11041079https://hdl.handle.net/20.500.14352/1048642023 Descuento MDPIThe use of venoarterial (VA) extracorporeal membrane oxygenation therapy (ECMO) in patients admitted to cardiac intensive care units (CICU) has increased. Data regarding infections in this population are scarce. In this retrospective study, we analyzed the risk factors, outcome, and predictors of in-hospital mortality due to nosocomial infections in patients with ECMO admitted to a single coronary intensive care unit between July 2013 and March 2019 treated with VA-ECMO for >48 h. From 69 patients treated with VA-ECMO >48 h, (median age 58 years), 29 (42.0%) patients developed 34 episodes of infections with an infection rate of 0.92/1000 ECMO days. The most frequent were ventilator-associated pneumonia (57.6%), tracheobronchitis (9.1%), bloodstream infections (9.1%), skin and soft tissue infections (9.1%), and cytomegalovirus reactivation (9.1%). In-hospital mortality was 47.8%, but no association with nosocomial infections was found (p = 0.75). The number of days on ECMO (OR 1.14, 95% CI 1.01–1.30, p = 0.029) and noninfectious complications were higher in the infected patients (OR: 3.8 95% CI = 1.05–14.1). A higher baseline creatinine value (OR: 8.2 95% CI = 1.12–60.2) and higher blood lactate level at 4 h after ECMO initiation (OR: 2.0 95% CI = 1.23–3.29) were significant and independent risk factors for mortality. Conclusions: Nosocomial infections in medical patients treated with VA-ECMO are very frequent, mostly Gram-negative respiratory infections. Preventive measures could play an important role for these patients.engAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/journal article2076-2607https://doi.org/10.3390/microorganisms11041079open access616.9616-036.22ECMOVenoarterial extracorporeal membrane oxygenationNosocomial infectionsCardiac intensive care unitCardiovascular infectionsEnfermedades infecciosasMicrobiología médica3201.03 Microbiología Clínica3202 Epidemiología