Extracorporeal membrane oxygenation increases recurrent bacteremia risk

There is a risk of recurrent Enterococcus bacteremia or Staphylococcus aureus bacteremia (SAB) in patients who stay on extracorporeal membrane oxygenation (ECMO) after antibiotics have been completed, says an article published in Heart & Lung: The Journal of Cardiopulmonary and Acute Care.

While there is guidance for managing blood stream infections with different invasive devices, there is presently little evidence to advise antibiotic selection and duration in patients getting extracorporeal membrane oxygenation. As a result, Joseph E. Marcus and colleagues undertook this study to assess the management and outcomes of thirty-six patients on ECMO with Staphylococcus aureus and Enterococcus bacteremia.

Blood culture data from patients with Staphylococcus aureus or Enterococcus bacteremia who received ECMO assistance at Brooke Army Medical Centre between March 2012 and September 2021 were analyzed retrospectively.

The key findings of this study were:

During the research period, 25 (9%) of the 282 patients who had ECMO acquired Enterococcus bacteremia, and 16 (6%) developed SAB. 

SAB occurred more frequently in ECMO than in Enterococcus (median day 2 IQR (1-5) vs. 22 (12-51), p = 0.01).