Objective To analyze the pathogenic bacteria distribution and risk factors of nosocomial infection in patients with extracorporeal membrane oxygenation (ECMO).
Methods Clinical materials of 76 patients with ECMO were analyzed, and they were divided into infection group and non-infection group. The infection situation and its risk factors as well as the distribution of detected pathogenic bacteria and their drug resistance were analyzed, and the risk factors of nosocomial infection after ECMO were analyzed by receiver operating characteristic (ROC) curve.
Results The incidence of nosocomial infection in 76 patients was 53.95% (41/76), lower respiratory tract (76.12%) was the main infection site, and the detection rate of Gram-negative bacilli was the highest (85.07%). There were significant differences in age, mechanical ventilation time, ECMO assisted time, antibacterial drug use time, central venous catheterization time and catheter catheterization time between the two groups (P < 0.05 or P < 0.01). Logistic regression analysis showed that ECMO assisted time and mechanical ventilation time were the independent risk factors for nosocomial infection (P < 0.05). ROC curve analysis showed that the area under the curve (AUC) of ECMO assisted time to predict nosocomial infection after ECMO was 0.812, the best critical value was 128.04 h, the sensitivity was 68.3%, and the specificity was 85.7%; the AUC of mechanical ventilation time in predicting nosocomial infection after ECMO was 0.873, the best critical value was 64.48 h, the sensitivity was 97.6%, and the specificity was 68.6%.
Conclusion The nosocomial infection rate after ECMO is high, the lower respiratory tract is the main infection site, and most of pathogenic bacteria are Gram-negative bacteria, the proportion of multidrug-resistant bacteria is high, and mechanical ventilation time and ECMO assisted time are the independent risk factors for nosocomial infection.
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