PULMONARY INFECTIONS IN PATIENTS RECEIVING EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) FOR SARS-COV2-RELATED ARDS
Chest
; 162(4):A509, 2022.
Article
in English
| EMBASE | ID: covidwho-2060616
ABSTRACT
SESSION TITLE Not the Normal Host Infections Still Matter SESSION TYPE Rapid Fire Original Inv PRESENTED ON 10/17/2022 1215 pm - 115 pm PURPOSE:
The purpose of this study is to determine the incidence of hospital acquired and ventilator associated pulmonary infections in patients on ECMO for SARS-CoV-2 related ARDS in relation to steroids and ECMO cannulation days.METHODS:
A retrospective analysis of COVID19 patients treated with ECMO admitted to a tertiary care academic medical center from January 2020 until July 2021 was conducted. Data including baseline patient characteristics, type, and duration of ECMO support, type and days of steroids use and sputum culture results were collected. An institutional review board (IRB) approval was obtained prior to data collection. A two-tailed T-test was used to calculate the P-value, P-value of <0.05 was considered significant.RESULTS:
A total of 34 patients were included in the analysis, of which 3 of them were on (Veno-Arterial) VA-ECMO and 31 were on (Veno-Venous) VV-ECMO. 32 out of 34 (94%) patients received steroids during their hospital course. Total of 20 patients had positive sputum cultures (59%) and average steroid days for patients with positive sputum cultures was 20.75 days as compared to 10.75 days for patients with negative sputum cultures (P-Value 0.01). Average ECMO days for patients with positive sputum cultures was 26 days as compared to 14.4 days for patients with negative sputum cultures (P Value 0.0003). Amongst the patients with positive sputum cultures, pseudomonas aeruginosa and methicillin-sensitive staphylococcus aureus (MSSA) were the most isolated organisms (25% of positive cultures), methicillin-resistant staphylococcus aureus (MRSA) and Serratia Marcescens were isolated in 20% of positive cultures, Klebsiella aerogenes was isolated in 15% of positive cultures.CONCLUSIONS:
Hospital acquired and ventilator associated pulmonary infections are common in patients on ECMO for SARS-CoV2 related ARDS. Longer ECMO days and a longer duration of steroid use were found to be associated with higher rates of bacterial growth in sputum cultures. Common organisms included Pseudomonas, MSSA, and MRSA. CLINICAL IMPLICATIONS Our analysis describes the most common bacterial organisms isolated on sputum cultures in this study population. It may also serve as a guide for empiric antibiotics choice when bacterial pneumonia is suspected in similar patients while awaiting sputum culture results. DISCLOSURES No relevant relationships by Varun Halani No relevant relationships Added 03/21/2022 by Ghassan Kamel, value=Honoraria Removed 03/21/2022 by Ghassan Kamel No relevant relationships Added 03/22/2022 by Ghassan Kamel, value=Honoraria Removed 03/22/2022 by Ghassan Kamel No relevant relationships by Ahmad Sharayah
antibiotic agent; steroid; adult; adult respiratory distress syndrome; antibiotic sensitivity; artificial ventilation; bacterial growth; bacterial pneumonia; bacterium culture; cannulation; clinical article; conference abstract; controlled study; coronavirus disease 2019; drug therapy; Enterobacter aerogenes; extracorporeal oxygenation; female; human; incidence; institutional review; male; methicillin resistant Staphylococcus aureus; methicillin susceptible Staphylococcus aureus; nonhuman; Pseudomonas aeruginosa; retrospective study; Serratia marcescens; Severe acute respiratory syndrome coronavirus 2; sputum culture; Staphylococcus aureus; tertiary health care; university hospital; veno-arterial ECMO; veno-venous ECMO; ventilator
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Chest
Year:
2022
Document Type:
Article
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