OBJECTIVE To explore the current status, etiological characteristics and risk factors for nosocomial infections in the patients who are treated with extracorporeal membrane oxygenation (ECMO) so as to provide bases for treatment and prevention of nosocomial infections in the ICU patients treated with ECMO.

METHODS The clinical data were retrospectively collected from the patients who were treated with ECMO in the ICU of Xinyang Central Hospital from Jan. 2021 to Dec. 2023. The patients were divided into the infection group and the non-infection group according the status of nosocomial infection during the ECMO treatment period. The constituent ratios of pathogens isolated from the patients with infections were recorded, and multivariate logistic regression analysis was performed for independent risk factors for the ECMO-related nosocomial infections.

RESULTS Of 86 patients who were finally enrolled in the study, 33 (38.37%) had nosocomial infections. Totally 54 strains of pathogens were isolated from the patients with the infections, 43 (79.63%) of which were gram-negative bacteria, 7 (12.97%) were gram-positive bacteria, and 4 (7.41%) were fungi. There were 36 (66.67%) strains of multidrug-resistant organisms (MDROs) among the 54 strains of pathogens, and 27 (81.82%) patients were detected with MDROs. Among the ECMO patients with postoperative nosocomial infections, 21 (63.64%) cases had pulmonary infections, 8 (24.24%) cases had bloodstream infection, and 4 (12.12%) had urinary system infections. Multivariate logistic analysis showed that the high blood glucose level at the beginning of treatment with ECMO, long duration of ECMO treatment and long time of central venous catheter indwelling were the independent risk factors for the nosocomial infections in the patients treated with ECMO(P<0.05).

CONCLUSION The isolation rate of gram-negative bacteria is relatively high among the pathogens isolated from the ECMO patients with postoperative nosocomial infections, and the drug resistance rates are high. The high blood glucose level, long duration of ECMO supporting treatment and long time of central venous catheter indwelling are the independent risk factors for the nosocomial infections in the patients treated with ECMO.