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Journal Articles Critical Care Year : 2024

Healthcare-associated infections in patients with severe COVID-19 supported with extracorporeal membrane oxygenation: a nationwide cohort study

Nicolas Nesseler (1, 2, 3) , Alexandre Mansour (4, 2, 1) , Matthieu Schmidt (5) , Marylou Para (6) , Alizée Porto (7) , Pierre-Emmanuel Falcoz (8) , Nicolas Mongardon (9) , Claire Fougerou (1, 2) , James Ross (10) , Antoine Beurton (11) , Lucie Gaide-Chevronnay (12) , Pierre-Grégoire Guinot , Guillaume Lebreton (5) , Erwan Flecher (1, 13) , André Vincentelli (14) , Nicolas Massart (15) , Olivier Fouquet , Marc Pierrot , Sidney Chocron , Guillaume Flicoteaux , Philippe Mauriat , Alexandre Ouattara , Hadrien Roze , Olivier Huet , Marc-Olivier Fischer , Raphel Bellaïche , Ophélie Constant , Quentin de Roux , L. André , Arnaud Meffert , Jean-Claude Merle , Lucile Picard , Elena Skripkina , Thierry Folliguet , Antonio Fiore , Nicolas D’ostrevy , Marie-Catherine Morgan , Maxime Nguyen , Nicolas Terzi , Gwenhaël Colin , Olivier Fabre , Arash Astaneh , Justin Issard , Elie Fadel , Dominique Fabre , Julien Guihaire , Iolande Ion , Jean Baptiste Menager , Delphine Mitilian , Olaf Mercier , François Stephan , Jacques Thes , Jerôme Jouan , Thibault Duburcq , Valentin Loobuyck , Mouhammed Moussa , Sabrina Manganiello , Agnes Mugnier , Natacha Rousse , Olivier Desebbe , Jean-Luc Fellahi , Roland Henaine , Matteo Pozzi , Zakaria Riad , Christophe Guervilly , Sami Hraiech , Laurent Papazian , Matthias Castanier , Charles Chanavaz , Cyril Cadoz , Sebastien Gette , Guillaume Louis , Erick Portocarrero , Philippe Gaudard , Kais Brini , Nicolas Bischoff , Antoine Kimmoun , Bruno Levy , Pierre Perez , Alexandre Bourdiol , Yannick Hourmant , Pierre-Joachim Mahé , Bertrand Rozec , Mickaël Vourc’h , Stéphane Aubert , Florian Bazalgette , Claire Roger , Pierre Jaquet , Brice Lortat-Jacob , Pierre Mordant , Patrick Nataf , Juliette Patrier , Sophie Provenchere , Morgan Roué , Romain Sonneville , Alexy Tran-Dinh , Paul-Henri Wicky , Charles Al Zreibi , Bernard Cholley , Yannis Guyonvarch , Sophie Hamada , Claudio Barbanti , Astrid Bertier , Anatole Harrois , Jordi Matiello , Thomas Kerforne , Corentin Lacroix , Nicolas Brechot , Alain Combes , Juliette Chommeloux , Cosimo D’alessandro , Pierre Demondion , Alexandre Demoule , Martin Dres , Guillaume Fadel , Muriel Fartoukh , Guillaume Hekimian , Charles Juvin , Pascal Leprince , David Levy , Charles Edouard Luyt , Thibaut Schoell , Pierre Fillâtre , Maud Jonas , Nicolas Allou , Salvatore Muccio , Dario Di Perna , Vito-Giovanni Ruggieri , Bruno Mourvillier , Amedeo Anselmi , Karl Bounader , Yoann Launey , Thomas Lebouvier , Alessandro Parasido , Florian Reizine , Maxime Esvan , Philippe Seguin , Emmanuel Besnier , Dorothée Carpentier , Thomas Clavier , Anne Olland , Marion Villard , Fanny Bounes , François Labaste , Vincent Minville , Antoine Guillon , Yannick Fedun
Pierre-Grégoire Guinot
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Olivier Fouquet
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Marc Pierrot
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Sidney Chocron
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Guillaume Flicoteaux
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Philippe Mauriat
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Alexandre Ouattara
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Hadrien Roze
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Olivier Huet
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Marc-Olivier Fischer
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Raphel Bellaïche
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Ophélie Constant
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Quentin de Roux
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L. André
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Arnaud Meffert
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Jean-Claude Merle
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Lucile Picard
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Elena Skripkina
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Thierry Folliguet
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Antonio Fiore
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Nicolas D’ostrevy
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Marie-Catherine Morgan
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Maxime Nguyen
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Nicolas Terzi
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Gwenhaël Colin
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Olivier Fabre
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Arash Astaneh
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Justin Issard
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Elie Fadel
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Dominique Fabre
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Julien Guihaire
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Iolande Ion
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Jean Baptiste Menager
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Delphine Mitilian
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Olaf Mercier
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François Stephan
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Jacques Thes
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Jerôme Jouan
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Thibault Duburcq
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Valentin Loobuyck
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Mouhammed Moussa
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Sabrina Manganiello
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Agnes Mugnier
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Natacha Rousse
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Olivier Desebbe
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Jean-Luc Fellahi
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Roland Henaine
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Matteo Pozzi
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Zakaria Riad
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Christophe Guervilly
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Sami Hraiech
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Laurent Papazian
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Matthias Castanier
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Charles Chanavaz
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Cyril Cadoz
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Sebastien Gette
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Guillaume Louis
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Erick Portocarrero
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Philippe Gaudard
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Kais Brini
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Nicolas Bischoff
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Antoine Kimmoun
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Bruno Levy
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Pierre Perez
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Alexandre Bourdiol
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Yannick Hourmant
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Pierre-Joachim Mahé
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Bertrand Rozec
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Mickaël Vourc’h
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Stéphane Aubert
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Florian Bazalgette
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Claire Roger
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Pierre Jaquet
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Brice Lortat-Jacob
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Pierre Mordant
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Patrick Nataf
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Juliette Patrier
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Sophie Provenchere
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Morgan Roué
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Romain Sonneville
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Alexy Tran-Dinh
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Paul-Henri Wicky
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Charles Al Zreibi
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Bernard Cholley
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Yannis Guyonvarch
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Sophie Hamada
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Claudio Barbanti
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Astrid Bertier
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Anatole Harrois
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Jordi Matiello
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Thomas Kerforne
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Corentin Lacroix
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Nicolas Brechot
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Alain Combes
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Juliette Chommeloux
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Cosimo D’alessandro
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Pierre Demondion
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Alexandre Demoule
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Martin Dres
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Guillaume Fadel
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Muriel Fartoukh
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Guillaume Hekimian
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Charles Juvin
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Pascal Leprince
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David Levy
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Charles Edouard Luyt
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Thibaut Schoell
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Pierre Fillâtre
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Maud Jonas
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Nicolas Allou
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Salvatore Muccio
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Dario Di Perna
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Vito-Giovanni Ruggieri
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Bruno Mourvillier
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Amedeo Anselmi
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Karl Bounader
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Yoann Launey
Thomas Lebouvier
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Alessandro Parasido
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Florian Reizine
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Maxime Esvan
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Philippe Seguin
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Emmanuel Besnier
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Dorothée Carpentier
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Thomas Clavier
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Anne Olland
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Marion Villard
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Fanny Bounes
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François Labaste
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Vincent Minville
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Antoine Guillon
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Yannick Fedun
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Abstract

Background Both critically ill patients with coronavirus disease 2019 (COVID-19) and patients receiving extracorporeal membrane oxygenation (ECMO) support exhibit a high incidence of healthcare-associated infections (HAI). However, data on incidence, microbiology, resistance patterns, and the impact of HAI on outcomes in patients receiving ECMO for severe COVID-19 remain limited. We aimed to report HAI incidence and microbiology in patients receiving ECMO for severe COVID-19 and to evaluate the impact of ECMO-associated infections (ECMO-AI) on in-hospital mortality. Methods For this study, we analyzed data from 701 patients included in the ECMOSARS registry which included COVID-19 patients supported by ECMO in France. Results Among 602 analyzed patients for whom HAI and hospital mortality data were available, 214 (36%) had ECMO-AI, resulting in an incidence rate of 27 ECMO-AI per 1000 ECMO days at risk. Of these, 154 patients had bloodstream infection (BSI) and 117 patients had ventilator-associated pneumonia (VAP). The responsible microorganisms were Enterobacteriaceae (34% for BSI and 48% for VAP), Enterococcus species (25% and 6%, respectively) and non-fermenting Gram-negative bacilli (13% and 20%, respectively). Fungal infections were also observed (10% for BSI and 3% for VAP), as were multidrug-resistant organisms (21% and 15%, respectively). Using a Cox multistate model, ECMO-AI were not found associated with hospital death (HR = 1.00 95% CI [0.79–1.26], p = 0.986). Conclusions In a nationwide cohort of COVID-19 patients receiving ECMO support, we observed a high incidence of ECMO-AI. ECMO-AI were not found associated with hospital death. Trial registration number NCT04397588 (May 21, 2020).
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hal-04477794 , version 1 (28-02-2024)

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Nicolas Nesseler, Alexandre Mansour, Matthieu Schmidt, Marylou Para, Alizée Porto, et al.. Healthcare-associated infections in patients with severe COVID-19 supported with extracorporeal membrane oxygenation: a nationwide cohort study. Critical Care, 2024, 28 (1), pp.54. ⟨10.1186/s13054-024-04832-3⟩. ⟨hal-04477794⟩
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