Background: This study aimed to investigate the incidence, associated factors, and outcomes of nosocomial infections (NIs) among adult patients supported by venoarterial extracorporeal membrane oxygenation (VA-ECMO). Methods: This retrospective study included 97 adult patients who underwent VA-ECMO between July 2020 and January 2025. All patients were treated in a single-center intensive care unit (ICU). The incidence, pathogen characteristics, associated factors, and outcomes of NIs were analyzed. Results: A total of 61 (62.89%) patients developed NIs. Acinetobacter baumannii was identified as the major pathogen. The hospital mortality rate for patients receiving VA-ECMO with NIs was 49.18%. A long ECMO duration (odds ratio (OR) = 1.26, 95% confidence interval (CI): 1.05–1.51; p = 0.013), blood transfusion (OR = 7.45, 95% CI: 1.89–29.28; p = 0.004), a long central venous catheterization (CVC) duration (OR = 1.13, 95% CI: 1.01–1.27; p = 0.041), and long ICU stay (OR = 1.14, 95% CI: 1.07–1.22; p < 0.001) were factors significantly associated with NIs. The occurrence of adverse events was positively related to that of death (OR = 11.85, 95% CI: 4.52–31.08; p < 0.001). A restricted cubic spline (RCS) revealed that when the ICU stay exceeded 24.13 days, the risk of NIs increased dramatically (p for nonlinearity = 0.036). Conclusions: NIs are common in ICU patients supported by VA-ECMO. Acinetobacter baumannii was identified as the most common microorganism associated with NI. Longer ECMO and CVC durations, blood transfusions, and a longer ICU stay were associated with NIs. The occurrence of adverse events early in the ICU increased the risk of death in ECMO-supported patients.
Chen et al. (Fri,) studied this question.