Impact of bloodstream infections on catheter colonization during extracorporeal membrane oxygenation

Background: There are concerns about secondary extracorporeal membrane oxygenation (ECMO) catheter infections in bacteremic patients. We investigated the association between blood stream infection (BSI) and ECMO catheter colonization. Method: From January 2012 to August 2014, a total of 47 adult patients who received ECMO support were enrolled. The ECMO catheter tip was cultured at the end of the ECMO procedure. The enrolled patients were classified into two groups according to the presence of BSI during ECMO support and analyzed in terms of ECMO catheter colonization. Results: Of 47 cases, BSI during ECMO were identified in 13 patients (27.7%). ECMO catheter colonization were identified in 6 patients (46.2%) of BSI group and in 3 patients (8.8%) of non-BSI group. The BSI during ECMO support was independently associated with ECMO catheter colonization (odds ratio [OR], 5.55; 95% confidence interval [CI], 1.00–30.73; p = 0.049). The colonized organisms on ECMO catheter in the setting of primary BSI were predominantly gram-positive cocci and Candida species. Otherwise, Acinetobacter baumanni was the most common colonized pathogens in the setting of secondary BSI. All the colonized organisms on ECMO catheter were multi-drug resistant organisms, including methicillin-resistant S. aureus , Candida glabrata , and carbapenem-resistant A. baumanni . Conclusions: ECMO catheter may become contaminated with multi-drug resistant pathogens in the presence of BSI. Therefore, ECMO should be cautiously applied in septic patients with bacteremia, caused by multi-drug resistant pathogens.