Incidence of candidaemia in prolonged venovenous extracorporeal membrane oxygenation.

J Hosp Infect

Department of Microbiology, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK.

Published: January 2022

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.

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http://dx.doi.org/10.1016/j.jhin.2021.09.014DOI Listing

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