Incidence, risk factors and outcomes of nosocomial infection in adult patients supported by extracorporeal membrane oxygenation: a systematic review and meta-analysis
<h3>Background</h3><p dir="ltr">An increasing number of patients requires extracorporeal membrane oxygenation (ECMO) for life support. This supportive modality is associated with nosocomial infections (NIs). This systematic review and meta-analysis aim to assess the incid...
محفوظ في:
| المؤلف الرئيسي: | |
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| مؤلفون آخرون: | , , , , |
| منشور في: |
2024
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| الموضوعات: | |
| الوسوم: |
إضافة وسم
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| _version_ | 1864513509683888128 |
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| author | Ali Ait Hssain (9538617) |
| author2 | Amir Vahedian-Azimi (11177056) Abdulsalam Saif Ibrahim (19325905) Ibrahim Fawzy Hassan (19325908) Elie Azoulay (20533) Michael Darmon (282176) |
| author2_role | author author author author author |
| author_facet | Ali Ait Hssain (9538617) Amir Vahedian-Azimi (11177056) Abdulsalam Saif Ibrahim (19325905) Ibrahim Fawzy Hassan (19325908) Elie Azoulay (20533) Michael Darmon (282176) |
| author_role | author |
| dc.creator.none.fl_str_mv | Ali Ait Hssain (9538617) Amir Vahedian-Azimi (11177056) Abdulsalam Saif Ibrahim (19325905) Ibrahim Fawzy Hassan (19325908) Elie Azoulay (20533) Michael Darmon (282176) |
| dc.date.none.fl_str_mv | 2024-05-10T09:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1186/s13054-024-04946-8 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Incidence_risk_factors_and_outcomes_of_nosocomial_infection_in_adult_patients_supported_by_extracorporeal_membrane_oxygenation_a_systematic_review_and_meta-analysis/26491111 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Clinical sciences Extracorporeal membrane oxygenation Incidence Meta-analysis Nosocomial infection Prevalence Risk factors |
| dc.title.none.fl_str_mv | Incidence, risk factors and outcomes of nosocomial infection in adult patients supported by extracorporeal membrane oxygenation: a systematic review and meta-analysis |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Background</h3><p dir="ltr">An increasing number of patients requires extracorporeal membrane oxygenation (ECMO) for life support. This supportive modality is associated with nosocomial infections (NIs). This systematic review and meta-analysis aim to assess the incidence and risk factors of NIs in adult.</p><h3>Methods</h3><p dir="ltr">We searched PubMed, Scopus, Web of Science, and ProQuest databases up to 2022. The primary endpoint was incidence of NI. Secondary endpoints included time to infection, source of infection, ECMO duration, Intensive care and hospital length of stay (LOS), ECMO survival and overall survival. Incidence of NI was reported as pooled proportions and 95% confidence intervals (CIs), while dichotomous outcomes were presented as risk ratios (RR) as the effective index and 95% CIs using a random-effects model.</p><h3>Results</h3><p dir="ltr">Among the 4,733 adult patients who received ECMO support in the 30 included studies, 1,249 ECMO-related NIs per 1000 ECMO-days was observed. The pooled incidence of NIs across 18 studies involving 3424 patients was 26% (95% CI 14–38%).Ventilator-associated pneumonia (VAP) and bloodstream infections (BSI) were the most common NI sources. Infected patients had lower ECMO survival and overall survival rates compared to non-infected patients, with risk ratio values of 0.84 (95% CI 0.74–0.96, <i>P</i> = 0.01) and 0.80 (95% CI 0.71–0.90, <i>P</i> < 0.001), respectively.</p><h3>Conclusion</h3><p dir="ltr">Results showed that 16% and 20% lower of ECMO survival and overall survival in patients with NI than patients without NI, respectively. However, NI increased the risk of in-hospital mortality by 37% in infected patients compared with non-infected patients. In addition, this study identified the significant positive correlation between ECMO duration and ECMO-related NI.</p><h2>Other Information</h2><p dir="ltr">Published in: Critical Care<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1186/s13054-024-04946-8" target="_blank">https://dx.doi.org/10.1186/s13054-024-04946-8</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_c513a05184b2031db8dc89f34b03c559 |
| identifier_str_mv | 10.1186/s13054-024-04946-8 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/26491111 |
| publishDate | 2024 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Incidence, risk factors and outcomes of nosocomial infection in adult patients supported by extracorporeal membrane oxygenation: a systematic review and meta-analysisAli Ait Hssain (9538617)Amir Vahedian-Azimi (11177056)Abdulsalam Saif Ibrahim (19325905)Ibrahim Fawzy Hassan (19325908)Elie Azoulay (20533)Michael Darmon (282176)Biomedical and clinical sciencesClinical sciencesExtracorporeal membrane oxygenationIncidenceMeta-analysisNosocomial infectionPrevalenceRisk factors<h3>Background</h3><p dir="ltr">An increasing number of patients requires extracorporeal membrane oxygenation (ECMO) for life support. This supportive modality is associated with nosocomial infections (NIs). This systematic review and meta-analysis aim to assess the incidence and risk factors of NIs in adult.</p><h3>Methods</h3><p dir="ltr">We searched PubMed, Scopus, Web of Science, and ProQuest databases up to 2022. The primary endpoint was incidence of NI. Secondary endpoints included time to infection, source of infection, ECMO duration, Intensive care and hospital length of stay (LOS), ECMO survival and overall survival. Incidence of NI was reported as pooled proportions and 95% confidence intervals (CIs), while dichotomous outcomes were presented as risk ratios (RR) as the effective index and 95% CIs using a random-effects model.</p><h3>Results</h3><p dir="ltr">Among the 4,733 adult patients who received ECMO support in the 30 included studies, 1,249 ECMO-related NIs per 1000 ECMO-days was observed. The pooled incidence of NIs across 18 studies involving 3424 patients was 26% (95% CI 14–38%).Ventilator-associated pneumonia (VAP) and bloodstream infections (BSI) were the most common NI sources. Infected patients had lower ECMO survival and overall survival rates compared to non-infected patients, with risk ratio values of 0.84 (95% CI 0.74–0.96, <i>P</i> = 0.01) and 0.80 (95% CI 0.71–0.90, <i>P</i> < 0.001), respectively.</p><h3>Conclusion</h3><p dir="ltr">Results showed that 16% and 20% lower of ECMO survival and overall survival in patients with NI than patients without NI, respectively. However, NI increased the risk of in-hospital mortality by 37% in infected patients compared with non-infected patients. In addition, this study identified the significant positive correlation between ECMO duration and ECMO-related NI.</p><h2>Other Information</h2><p dir="ltr">Published in: Critical Care<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1186/s13054-024-04946-8" target="_blank">https://dx.doi.org/10.1186/s13054-024-04946-8</a></p>2024-05-10T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1186/s13054-024-04946-8https://figshare.com/articles/journal_contribution/Incidence_risk_factors_and_outcomes_of_nosocomial_infection_in_adult_patients_supported_by_extracorporeal_membrane_oxygenation_a_systematic_review_and_meta-analysis/26491111CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/264911112024-05-10T09:00:00Z |
| spellingShingle | Incidence, risk factors and outcomes of nosocomial infection in adult patients supported by extracorporeal membrane oxygenation: a systematic review and meta-analysis Ali Ait Hssain (9538617) Biomedical and clinical sciences Clinical sciences Extracorporeal membrane oxygenation Incidence Meta-analysis Nosocomial infection Prevalence Risk factors |
| status_str | publishedVersion |
| title | Incidence, risk factors and outcomes of nosocomial infection in adult patients supported by extracorporeal membrane oxygenation: a systematic review and meta-analysis |
| title_full | Incidence, risk factors and outcomes of nosocomial infection in adult patients supported by extracorporeal membrane oxygenation: a systematic review and meta-analysis |
| title_fullStr | Incidence, risk factors and outcomes of nosocomial infection in adult patients supported by extracorporeal membrane oxygenation: a systematic review and meta-analysis |
| title_full_unstemmed | Incidence, risk factors and outcomes of nosocomial infection in adult patients supported by extracorporeal membrane oxygenation: a systematic review and meta-analysis |
| title_short | Incidence, risk factors and outcomes of nosocomial infection in adult patients supported by extracorporeal membrane oxygenation: a systematic review and meta-analysis |
| title_sort | Incidence, risk factors and outcomes of nosocomial infection in adult patients supported by extracorporeal membrane oxygenation: a systematic review and meta-analysis |
| topic | Biomedical and clinical sciences Clinical sciences Extracorporeal membrane oxygenation Incidence Meta-analysis Nosocomial infection Prevalence Risk factors |