Incidence of candidaemia in prolonged venovenous extracorporeal membrane oxygenation

E. J.M. Monk; R. Rautemaa-Richardson; T. Felton; A. Montalti; M. Parkes; R. Templeton; A. Ashworth; M. Garcia; J. Barker; S. Thomas

doi:10.1016/j.jhin.2021.09.014

Incidence of candidaemia in prolonged venovenous extracorporeal membrane oxygenation

E. J.M. Monk^*, R. Rautemaa-Richardson, T. Felton, A. Montalti, M. Parkes, R. Templeton, A. Ashworth, M. Garcia, J. Barker, S. Thomas

^*Corresponding author for this work

University Hospital of South Manchester NHS Foundation Trust

Research output: Contribution to journal › Article › peer-review

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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.

Original language	English
Pages (from-to)	49-53
Number of pages	5
Journal	Journal of Hospital Infection
Volume	119
Early online date	22 Sept 2021
DOIs	https://doi.org/10.1016/j.jhin.2021.09.014
Publication status	Published - 1 Jan 2022

Keywords

Candida
ECMO
Intensive care
Nosocomial
Yeast

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10.1016/j.jhin.2021.09.014

ECMO Manuscript Final JHI Short Report RevisionAccepted author manuscript, 351 KBLicence: CC BY-NC-ND

MFIG: Manchester Fungal Infection Group (MFIG)
Bromley, M. (PI), Bertuzzi, M. (PI), Gago, S. (PI), Denning, D. (PI), Kosmidis, C. (PI), Bowyer, P. (PI), Amich Elias, J. (PI), Richardson, M. (PI), Richardson, R. (PI), Van Rhijn, N. (PI) & Bottery, M. (PI)
15/08/13 → …
Project: Research

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@article{0c19341c309b42e4bb30767716ca9691,

title = "Incidence of candidaemia in prolonged venovenous extracorporeal membrane oxygenation",

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",

author = "Monk, {E. J.M.} and R. Rautemaa-Richardson and T. Felton and A. Montalti and M. Parkes and R. Templeton and A. Ashworth and M. Garcia and J. Barker and S. Thomas",

note = "Funding Information: RR-R and TF are supported by the NIHR Manchester Biomedical Research Centre . Publisher Copyright: {\textcopyright} 2021 The Healthcare Infection Society",

year = "2022",

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doi = "10.1016/j.jhin.2021.09.014",

language = "English",

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TY - JOUR

T1 - Incidence of candidaemia in prolonged venovenous extracorporeal membrane oxygenation

AU - Monk, E. J.M.

AU - Rautemaa-Richardson, R.

AU - Felton, T.

AU - Montalti, A.

AU - Parkes, M.

AU - Templeton, R.

AU - Ashworth, A.

AU - Garcia, M.

AU - Barker, J.

AU - Thomas, S.

PY - 2022/1/1

Y1 - 2022/1/1

N2 - 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.

AB - 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.

KW - Candida

KW - ECMO

KW - Intensive care

KW - Nosocomial

KW - Yeast

U2 - 10.1016/j.jhin.2021.09.014

DO - 10.1016/j.jhin.2021.09.014

M3 - Article

C2 - 34562545

AN - SCOPUS:85121155275

SN - 0195-6701

VL - 119

SP - 49

EP - 53

JO - Journal of Hospital Infection

JF - Journal of Hospital Infection

ER -

Incidence of candidaemia in prolonged venovenous extracorporeal membrane oxygenation

Abstract

Keywords

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Projects

MFIG: Manchester Fungal Infection Group (MFIG)

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