Incidence of candidaemia in prolonged venovenous extracorporeal membrane oxygenation

J Hosp Infect. 2022 Jan;119:49-53. doi: 10.1016/j.jhin.2021.09.014. Epub 2021 Sep 22.

Abstract

This single-centre retrospective study reports the dynamics of the incidence of candida bloodstream infection (CBSI) in 145 patients receiving venovenous extracorporeal membrane oxygenation (ECMO) for respiratory support between January 2014 and December 2018. The incidence rate and odds ratio (OR) of CBSI were calculated, stratified by week of ECMO exposure. Weekly incidence increased throughout the ECMO run, with an increasing trend in OR (P=0.005), and a window of continued risk after decannulation was observed. Of the 13 patients who developed CBSI, five (38%) received empirical micafungin treatment before positive culture due to clinical suspicion. There is a need for prospective studies aiming to improve ECMO diagnostic stewardship practices and discourage unnecessary antifungal prophylaxis or empiric management.

Keywords: Candida; ECMO; Intensive care; Nosocomial; Yeast.

MeSH terms

  • Candidemia* / epidemiology
  • Extracorporeal Membrane Oxygenation* / adverse effects
  • Humans
  • Incidence
  • Prospective Studies
  • Retrospective Studies