HOSPITAL-ACQUIRED INFECTION RATES IN PATIENTS RECEIVING EXTRACORPOREAL MEMBRANE OXYGENATION ACROSS AUSTRALIA AND NEW ZEALAND
Ms Amanda Corley1,2, Ms India Lye2, Dr Jayshree Lavana3, Dr Abhilasha Ahuja3, Assoc Prof Chris Anstey2,4, Ms Emma Haisz5, Assoc Prof Rachael Parke6, Ms Claire Reynolds8, Dr Hergen Buscher8, Dr Vin Pellegrino7, Prof John Fraser2,3
1Royal Brisbane And Women’s Hospital/Griffith University, Herston, Australia
2Critical Care Research Group, The Prince Charles Hospital and University of Queensland, Chermside, Australia
3Adult Intensive Care Services, The Prince Charles Hospital, Chermside, Australia
4Griffith University, School of Medicine, BIrtinya, Australia
5Queensland Children’s Hospital, South Brisbane, Australia
6Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital, Auckland, New Zealand
7Department of Intensive Care, Alfred Hospital, Melbourne, Australia
8Department of Intensive Care Medicine, St Vincent’s Hospital, Sydney, Australia
Introduction: Extracorporeal membrane oxygenation (ECMO) is a highly invasive method of cardiac and/or pulmonary support for critically ill patients where less invasive therapies have failed. Hospital-acquired infection (HAI) is a frequent and serious complication of ECMO and is reported in up to 64% of patients. Limited data on HAI exists in these patients in Australia and New Zealand. We aim to determine HAI prevalence in patients receiving ECMO.
Methods: A prospective point-prevalence study of adult, paediatric and neonatal patients receiving ECMO in 11 Australian and New Zealand intensive care units was undertaken for one week per month over 12 months.
Results: 127 patients were enrolled; 100 adult, 20 paediatric, 7 neonate. Adult age range was 17-77 years (mean 46 years±15), paediatric 39 days to 15 years (6 years±6), and neonate 1-25 days (14 days±10). Sixty-one percent were male. Fifty-six percent of patients received VA ECMO, 40% received VV ECMO. Mean days on ECMO at time of data collection was 6.2±6.9. Fifty confirmed or suspected HAIs were documented. There were nine confirmed bloodstream infections: four Staphylococcus species, four Candida species and one Enterobacter species. Twenty-one other confirmed nosocomial infections (19 respiratory, one reproductive, one urinary) and 20 suspected infections (16 respiratory, two from an unknown source, one ECMO cannula, one urinary) were identified. In 80% of suspected hospital-acquired infections, antibiotics were commenced or changed.
Conclusions: HAI prevalence in patients receiving ECMO in Australia and New Zealand is high. Infection prevention through targeted interventions must be a priority for clinicians and researchers.
Biography:
Amanda is an experienced intensive care nurse with 25 years’ experience and specialties in cardiac surgical and respiratory critical care. She has published >45 peer reviewed articles, and book chapters. She completed a Masters of Advanced Practice (Health Care Research) in 2014 and is currently completing her PhD.
Amanda has particular expertise and interest in the management and care of vascular access devices, particularly ECMO (Extra Corporeal Membrane Oxygenation) cannula. She is a Conjoint Research Fellow with Griffith University and the Royal Brisbane and Women’s Hospital.