Extracorporeal membrane oxygenation and bloodstream infection in congenital diaphragmatic hernia.

Document Type

Article

Publication Date

10-2019

Identifier

DOI: 10.1038/s41372-019-0435-5

Abstract

OBJECTIVE: To characterize the risk of bloodstream (BSI) and urinary tract infection (UTI) and describe antibiotic use in infants with congenital diaphragmatic hernia (CDH) requiring extracorporeal membrane oxygenation (ECMO).

STUDY DESIGN: The Children's Hospitals Neonatal Database was queried for infants with CDH and ECMO treatment from 2010 to 2016. The outcomes included BSI, UTI, and antimicrobial medication. Member institutions completed a survey on infection practices.

RESULT: Eighteen of the 338 patients identified (5.3%) had ≥1 BSI during their ECMO course. The likelihood of BSI increased with time: 1.2/1000 ECMO days; 0.6% (2/315) in the first week and rising to 14.6/1000; 8.6% (5/58) after 21 days (p = 0.002). More than 95% of patients received antibiotics each week on ECMO.

CONCLUSIONS: Confirmed BSI is rare in infants with CDH treated with ECMO in the first week, but increases with the duration of ECMO. Use of antibiotics was extensive and did not correspond to infection frequency.

Journal Title

Journal of perinatology : official journal of the California Perinatal Association

Volume

39

Issue

10

First Page

1384

Last Page

1391

MeSH Keywords

Anti-Bacterial Agents; Bacteremia; Enterobacter; Escherichia coli; Extracorporeal Membrane Oxygenation; Female; Hernias, Diaphragmatic, Congenital; Humans; Infant, Newborn; Male; Proteus; Risk Factors; Staphylococcus aureus; Urinary Tract Infections

Keywords

Anti-Bacterial Agents; Bacteremia; Enterobacter; Escherichia coli; Extracorporeal Membrane Oxygenation; Female; Hernias, Diaphragmatic, Congenital; Humans; Infant, Newborn; Male; Proteus; Risk Factors; Staphylococcus aureus; Urinary Tract Infections

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