Ms. India Pearse1, Dr Amanda Corley2, Dr Nicole Bartnikowski3, Dr Jayshree Lavana1, Dr Abhilasha Ahuja1, Dr Robert Horvath1, Dr Yue Qu4, Prof David McGiffin5, Prof John Fraser6
1The Prince Charles Hospital, Chermside, Australia, 2Griffith University, Brisbane, Australia, 3Queensland University of Technology, Brisbane, Australia, 4Monash University, Melbourne, Australia, 5The Alfred Hospital, Melbourne, Australia, 6University of Queensland, Brisbane, Australia
Biography:
India is a Nurse Researcher with the Critical Care Research Group at The Prince Charles Hospital.
Abstract:
Introduction
Extracorporeal membrane oxygenation (ECMO) cannula-related infection is difficult to both diagnose and treat in the clinical setting. The aim of this study was to describe ECMO cannula colonisation and infection in the adult patient cohort, specifically types of bacteria and mechanisms of colonisation and biofilm construction.
Methods
This was a single centre, prospective, observational study of ECMO cannulae from adult patients in the medical and cardiac surgical intensive care unit of a tertiary referral centre in Brisbane, Australia. Cannulae were collected under sterile conditions upon the cessation of ECMO. Cannula specimens, blood specimens and cannula insertion site swabs were analysed using a combination of culture techniques and scanning electron microscopy (SEM).
Results
Forty-two patients were screened for eligibility, 20 of whom were consented and 11 included in the final analysis. Patients were male (64%), with a median APACHE II score of 17 (IQR 13, 20) and a mean ECMO duration of 11 days (SD 8 days). Of 23 cannulas, 30% were colonised with microorganisms. Macrocolony and monolayer biofilms (P. aeruginosa and Candida sp. respectively) were imaged via SEM on the access cannula of one patient. All patients received at least two antimicrobial agents during their ECMO treatment but only five (46%) patients developed nosocomial infections. No ECMO cannula-related BSIs were identified.
Conclusion
ECMO cannula-related colonisation and infection, whilst difficult to diagnose, presents a clinical problem which needs to be the subject of future research to improve outcomes for ECMO patients.