NOSOCOMIAL INFECTIONS IN NEONATES RECEIVING EXTRACORPOREAL MEMBRANE-OXYGENATION

OBJECTIVE: To determine the incidence of, and risk factors for, nosoco mial infections in neonates during and after treatment with extracorpo real membrane oxygenation (ECMO). DESIGN: A retrospective cohort study of all infants treated with ECMO during a 4-year period. PATIENTS: 26 neonates experiencing 32 nosocomial infections, and 54 neonates with no nosocomial infections. SETTING: A large, urban children's hospital. RESULTS: 30% of neonates treated with ECMO experienced at least one n osocomial infection. The rate of nosocomial infections was 10.3 per 1, 000 patient-days. Risk factors significantly associated with nosocomia l infection included duration of ECMO >7 days (mean, 12 vs 7 days; odd s ratio [OR], 2.84; 95% confidence interval [CI95], 0.96-8.56); neonat al intensive care-unit stay >21 days (mean, 44 vs 19 days; OR, 8.73; C I95, 2.49-31.94); hospitalization >50 days (mean, 63 vs 29 days; OR, 5 .44; CI95, 1.47-20.87); and surgical procedure before or during ECMO ( 46% vs 22%; OR, 4.58; CI95, 1.25 to 17.38). CONCLUSIONS: Nosocomial in fections occurred in 30% of patients undergoing ECMO. Although nosocom ial infections were not associated with an increase in mortality, hosp italization was prolonged.