Healthcare-associated infections in patients with severe COVID-19 supported with extracorporeal membrane oxygenation: a nationwide cohort study
Nicolas Nesseler
(1, 2, 3)
,
Alexandre Mansour
(4, 2, 1)
,
Matthieu Schmidt
(5)
,
Marylou Para
(6)
,
Alizée Porto
(7)
,
Pierre-Emmanuel Falcoz
(8)
,
Nicolas Mongardon
(9)
,
Claire Fougerou
(1, 2)
,
James Ross
(10)
,
Antoine Beurton
(11)
,
Lucie Gaide-Chevronnay
(12)
,
Pierre-Grégoire Guinot
,
Guillaume Lebreton
(5)
,
Erwan Flecher
(1, 13)
,
André Vincentelli
(14)
,
Nicolas Massart
(15)
,
Olivier Fouquet
,
Marc Pierrot
,
Sidney Chocron
,
Guillaume Flicoteaux
,
Philippe Mauriat
,
Alexandre Ouattara
,
Hadrien Roze
,
Olivier Huet
,
Marc-Olivier Fischer
,
Raphel Bellaïche
,
Ophélie Constant
,
Quentin de Roux
,
L. André
,
Arnaud Meffert
,
Jean-Claude Merle
,
Lucile Picard
,
Elena Skripkina
,
Thierry Folliguet
,
Antonio Fiore
,
Nicolas D’ostrevy
,
Marie-Catherine Morgan
,
Maxime Nguyen
,
Nicolas Terzi
,
Gwenhaël Colin
,
Olivier Fabre
,
Arash Astaneh
,
Justin Issard
,
Elie Fadel
,
Dominique Fabre
,
Julien Guihaire
,
Iolande Ion
,
Jean Baptiste Menager
,
Delphine Mitilian
,
Olaf Mercier
,
François Stephan
,
Jacques Thes
,
Jerôme Jouan
,
Thibault Duburcq
,
Valentin Loobuyck
,
Mouhammed Moussa
,
Sabrina Manganiello
,
Agnes Mugnier
,
Natacha Rousse
,
Olivier Desebbe
,
Jean-Luc Fellahi
,
Roland Henaine
,
Matteo Pozzi
,
Zakaria Riad
,
Christophe Guervilly
,
Sami Hraiech
,
Laurent Papazian
,
Matthias Castanier
,
Charles Chanavaz
,
Cyril Cadoz
,
Sebastien Gette
,
Guillaume Louis
,
Erick Portocarrero
,
Philippe Gaudard
,
Kais Brini
,
Nicolas Bischoff
,
Antoine Kimmoun
,
Bruno Levy
,
Pierre Perez
,
Alexandre Bourdiol
,
Yannick Hourmant
,
Pierre-Joachim Mahé
,
Bertrand Rozec
,
Mickaël Vourc’h
,
Stéphane Aubert
,
Florian Bazalgette
,
Claire Roger
,
Pierre Jaquet
,
Brice Lortat-Jacob
,
Pierre Mordant
,
Patrick Nataf
,
Juliette Patrier
,
Sophie Provenchere
,
Morgan Roué
,
Romain Sonneville
,
Alexy Tran-Dinh
,
Paul-Henri Wicky
,
Charles Al Zreibi
,
Bernard Cholley
,
Yannis Guyonvarch
,
Sophie Hamada
,
Claudio Barbanti
,
Astrid Bertier
,
Anatole Harrois
,
Jordi Matiello
,
Thomas Kerforne
,
Corentin Lacroix
,
Nicolas Brechot
,
Alain Combes
,
Juliette Chommeloux
,
Cosimo D’alessandro
,
Pierre Demondion
,
Alexandre Demoule
,
Martin Dres
,
Guillaume Fadel
,
Muriel Fartoukh
,
Guillaume Hekimian
,
Charles Juvin
,
Pascal Leprince
,
David Levy
,
Charles Edouard Luyt
,
Thibaut Schoell
,
Pierre Fillâtre
,
Maud Jonas
,
Nicolas Allou
,
Salvatore Muccio
,
Dario Di Perna
,
Vito-Giovanni Ruggieri
,
Bruno Mourvillier
,
Amedeo Anselmi
,
Karl Bounader
,
Yoann Launey
,
Thomas Lebouvier
,
Alessandro Parasido
,
Florian Reizine
,
Maxime Esvan
,
Philippe Seguin
,
Emmanuel Besnier
,
Dorothée Carpentier
,
Thomas Clavier
,
Anne Olland
,
Marion Villard
,
Fanny Bounes
,
François Labaste
,
Vincent Minville
,
Antoine Guillon
,
Yannick Fedun
1
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
2 CIC - Centre d'Investigation Clinique [Rennes]
3 NuMeCan - Nutrition, Métabolismes et Cancer
4 Irset - Institut de recherche en santé, environnement et travail
5 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases
6 LVTS (UMR_S_1148 / U1148) - Laboratoire de Recherche Vasculaire Translationnelle
7 APHM - Assistance Publique - Hôpitaux de Marseille
8 NanoRegMed - Nanomédecine Régénérative
9 IMRB - Institut Mondor de Recherche Biomédicale
10 Case Western Reserve University [Cleveland]
11 Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
12 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
13 LTSI - Laboratoire Traitement du Signal et de l'Image
14 RNMCD - Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011
15 CH Saint-Brieuc - Centre hospitalier de Saint-Brieuc [Hôpital Yves Le Foll]
2 CIC - Centre d'Investigation Clinique [Rennes]
3 NuMeCan - Nutrition, Métabolismes et Cancer
4 Irset - Institut de recherche en santé, environnement et travail
5 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases
6 LVTS (UMR_S_1148 / U1148) - Laboratoire de Recherche Vasculaire Translationnelle
7 APHM - Assistance Publique - Hôpitaux de Marseille
8 NanoRegMed - Nanomédecine Régénérative
9 IMRB - Institut Mondor de Recherche Biomédicale
10 Case Western Reserve University [Cleveland]
11 Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
12 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
13 LTSI - Laboratoire Traitement du Signal et de l'Image
14 RNMCD - Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011
15 CH Saint-Brieuc - Centre hospitalier de Saint-Brieuc [Hôpital Yves Le Foll]
Nicolas Nesseler
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- Function : Correspondent author
- PersonId : 945761
- ORCID : 0000-0003-4981-5588
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Pierre-Grégoire Guinot
- Function : Author
Olivier Fouquet
- Function : Author
Marc Pierrot
- Function : Author
Sidney Chocron
- Function : Author
Guillaume Flicoteaux
- Function : Author
Philippe Mauriat
- Function : Author
Alexandre Ouattara
- Function : Author
Hadrien Roze
- Function : Author
Olivier Huet
- Function : Author
Marc-Olivier Fischer
- Function : Author
Raphel Bellaïche
- Function : Author
Ophélie Constant
- Function : Author
Quentin de Roux
- Function : Author
L. André
- Function : Author
Arnaud Meffert
- Function : Author
Jean-Claude Merle
- Function : Author
Lucile Picard
- Function : Author
Elena Skripkina
- Function : Author
Thierry Folliguet
- Function : Author
Antonio Fiore
- Function : Author
Nicolas D’ostrevy
- Function : Author
Marie-Catherine Morgan
- Function : Author
Maxime Nguyen
- Function : Author
Nicolas Terzi
- Function : Author
Gwenhaël Colin
- Function : Author
Olivier Fabre
- Function : Author
Arash Astaneh
- Function : Author
Justin Issard
- Function : Author
Elie Fadel
- Function : Author
Dominique Fabre
- Function : Author
Julien Guihaire
- Function : Author
Iolande Ion
- Function : Author
Jean Baptiste Menager
- Function : Author
Delphine Mitilian
- Function : Author
Olaf Mercier
- Function : Author
François Stephan
- Function : Author
Jacques Thes
- Function : Author
Jerôme Jouan
- Function : Author
Thibault Duburcq
- Function : Author
Valentin Loobuyck
- Function : Author
Mouhammed Moussa
- Function : Author
Sabrina Manganiello
- Function : Author
Agnes Mugnier
- Function : Author
Natacha Rousse
- Function : Author
Olivier Desebbe
- Function : Author
Jean-Luc Fellahi
- Function : Author
Roland Henaine
- Function : Author
Matteo Pozzi
- Function : Author
Zakaria Riad
- Function : Author
Christophe Guervilly
- Function : Author
Sami Hraiech
- Function : Author
Laurent Papazian
- Function : Author
Matthias Castanier
- Function : Author
Charles Chanavaz
- Function : Author
Cyril Cadoz
- Function : Author
Sebastien Gette
- Function : Author
Guillaume Louis
- Function : Author
Erick Portocarrero
- Function : Author
Philippe Gaudard
- Function : Author
Kais Brini
- Function : Author
Nicolas Bischoff
- Function : Author
Antoine Kimmoun
- Function : Author
Bruno Levy
- Function : Author
Pierre Perez
- Function : Author
Alexandre Bourdiol
- Function : Author
Yannick Hourmant
- Function : Author
Pierre-Joachim Mahé
- Function : Author
Bertrand Rozec
- Function : Author
Mickaël Vourc’h
- Function : Author
Stéphane Aubert
- Function : Author
Florian Bazalgette
- Function : Author
Claire Roger
- Function : Author
Pierre Jaquet
- Function : Author
Brice Lortat-Jacob
- Function : Author
Pierre Mordant
- Function : Author
Patrick Nataf
- Function : Author
Juliette Patrier
- Function : Author
Sophie Provenchere
- Function : Author
Morgan Roué
- Function : Author
Romain Sonneville
- Function : Author
Alexy Tran-Dinh
- Function : Author
Paul-Henri Wicky
- Function : Author
Charles Al Zreibi
- Function : Author
Bernard Cholley
- Function : Author
Yannis Guyonvarch
- Function : Author
Sophie Hamada
- Function : Author
Claudio Barbanti
- Function : Author
Astrid Bertier
- Function : Author
Anatole Harrois
- Function : Author
Jordi Matiello
- Function : Author
Thomas Kerforne
- Function : Author
Corentin Lacroix
- Function : Author
Nicolas Brechot
- Function : Author
Alain Combes
- Function : Author
Juliette Chommeloux
- Function : Author
Cosimo D’alessandro
- Function : Author
Pierre Demondion
- Function : Author
Alexandre Demoule
- Function : Author
Martin Dres
- Function : Author
Guillaume Fadel
- Function : Author
Muriel Fartoukh
- Function : Author
Guillaume Hekimian
- Function : Author
Charles Juvin
- Function : Author
Pascal Leprince
- Function : Author
David Levy
- Function : Author
Charles Edouard Luyt
- Function : Author
Thibaut Schoell
- Function : Author
Pierre Fillâtre
- Function : Author
Maud Jonas
- Function : Author
Nicolas Allou
- Function : Author
Salvatore Muccio
- Function : Author
Dario Di Perna
- Function : Author
Vito-Giovanni Ruggieri
- Function : Author
Bruno Mourvillier
- Function : Author
Amedeo Anselmi
- Function : Author
Karl Bounader
- Function : Author
Yoann Launey
- Function : Author
Thomas Lebouvier
- Function : Author
Alessandro Parasido
- Function : Author
Florian Reizine
- Function : Author
Maxime Esvan
- Function : Author
Philippe Seguin
- Function : Author
Emmanuel Besnier
- Function : Author
Dorothée Carpentier
- Function : Author
Thomas Clavier
- Function : Author
Anne Olland
- Function : Author
Marion Villard
- Function : Author
Fanny Bounes
- Function : Author
François Labaste
- Function : Author
Vincent Minville
- Function : Author
Antoine Guillon
- Function : Author
Yannick Fedun
- Function : Author
Abstract
Background Both critically ill patients with coronavirus disease 2019 (COVID-19) and patients receiving extracorporeal membrane oxygenation (ECMO) support exhibit a high incidence of healthcare-associated infections (HAI). However, data on incidence, microbiology, resistance patterns, and the impact of HAI on outcomes in patients receiving ECMO for severe COVID-19 remain limited. We aimed to report HAI incidence and microbiology in patients receiving ECMO for severe COVID-19 and to evaluate the impact of ECMO-associated infections (ECMO-AI) on in-hospital mortality. Methods For this study, we analyzed data from 701 patients included in the ECMOSARS registry which included COVID-19 patients supported by ECMO in France. Results Among 602 analyzed patients for whom HAI and hospital mortality data were available, 214 (36%) had ECMO-AI, resulting in an incidence rate of 27 ECMO-AI per 1000 ECMO days at risk. Of these, 154 patients had bloodstream infection (BSI) and 117 patients had ventilator-associated pneumonia (VAP). The responsible microorganisms were Enterobacteriaceae (34% for BSI and 48% for VAP), Enterococcus species (25% and 6%, respectively) and non-fermenting Gram-negative bacilli (13% and 20%, respectively). Fungal infections were also observed (10% for BSI and 3% for VAP), as were multidrug-resistant organisms (21% and 15%, respectively). Using a Cox multistate model, ECMO-AI were not found associated with hospital death (HR = 1.00 95% CI [0.79–1.26], p = 0.986). Conclusions In a nationwide cohort of COVID-19 patients receiving ECMO support, we observed a high incidence of ECMO-AI. ECMO-AI were not found associated with hospital death. Trial registration number NCT04397588 (May 21, 2020).
Origin : Publisher files allowed on an open archive
licence : CC BY - Attribution
licence : CC BY - Attribution