ArticleAnnals of intensive care2019
Gastrointestinal colonization with multidrug-resistant Gram-negative bacteria during extracorporeal membrane oxygenation: effect on the risk of subsequent infections and impact on patient outcome.
Article in Annals of intensive care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 21 citations in OpenAlex.
- Gut colonization with multidrug-resistant organisms in hospitalized patients with gastrointestinal illness: A single-centre, cross-sectional study.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026Article
- Multidrug-resistant colonization in decompensated cirrhosis outside the ICU predicts infection and poor outcomes.JHEP reports : innovation in hepatology · 2026Article
- Article
- Predictors of Postoperative Hospital-Acquired Infection and Mortality Following Cardiac Surgery in a Low-Income Country: A Retrospective Cohort Study.Brazilian journal of cardiovascular surgery · 2025Article
- Retrospective ANalysis of multi-drug resistant Gram-nEgative bacteRia on veno-venous extracorporeal membrane oxygenation. The multicenter RANGER STUDY.Critical care (London, England) · 2024Article
- Gut residentmedRxiv : the preprint server for health sciences · 2024Article
- Role of multidrug-resistant bacteria in weaning from invasive mechanical ventilation.Respiratory research · 2024Article
- Clinical characteristics and risk factors for mortality in pneumonia-associated acute respiratory distress syndrome patients: a single center retrospective cohort study.Frontiers in cellular and infection microbiology · 2024Article
- Colonisation with Extended-Spectrum Cephalosporin-Resistant Enterobacterales and Infection Risk in Surgical Patients: A Systematic Review and Meta-analysis.Infectious diseases and therapy · 2023Article
- The Etiological and Drug Resistance Characteristics of Multidrug-Resistant Pathogens in Patients Requiring Extracorporeal Membrane Oxygenation: A Retrospective Cohort Study.Infection and drug resistance · 2023Article
- Associations of the skin, oral and gut microbiome with aging, frailty and infection risk reservoirs in older adults.Nature aging · 2022Article
- Clinical Implications of Multi-Drug Resistant Organisms' Gastrointestinal Colonization in an Internal Medicine Ward: The Pandora's Box.Journal of clinical medicine · 2022Article
- Evaluation of Bacterial Coinfection and Antibiotic Resistance in Patients with COVID-19 Under Mechanical Ventilation.SN comprehensive clinical medicine · 2022Article
- Article
- Carbapenem-resistant Klebsiella pneumoniae in ICU-admitted COVID-19 patients: Keep an eye on the ball.Journal of global antimicrobial resistance · 2020Article
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn ICU patients, digestive tract colonization by multidrug-resistant (MDR) Gram-negative (G-) bacteria is a significant risk factor for the development of infections. In patients undergoing extracorporeal membrane oxygenation (ECMO), colonization by MDR bacteria and risk of subsequent nosocomial infections (NIs) have not been studied yet. The aim of this study is to evaluate the incidence, etiology, risk factors, impact on outcome of gastrointestinal colonization by MDR G- bacteria, and risk of subsequent infections in patients undergoing ECMO.
methodsThis is a retrospective analysis of prospectively collected data: 105 consecutive patients, treated with ECMO, were admitted to the ICU of an Italian tertiary referral center (San Gerardo Hospital, Monza, Italy) from January 2010 to November 2015. Rectal swabs for MDR G- bacteria were cultured at admission and twice a week. Only colonization and NIs by MDR G- bacteria were analyzed.
resultsNinety-one included patients [48.5 (37-56) years old, 63% male, simplified acute physiology score II 37 (32-47)] underwent peripheral ECMO (87% veno-venous) for medical indications (79% ARDS). Nineteen (21%) patients were colonized by MDR G- bacteria. Male gender (OR 4.03, p = 0.029) and duration of mechanical ventilation (MV) before ECMO > 3 days (OR 3.57, p = 0.014) were associated with increased risk of colonization. Colonized patients had increased odds of infections by the colonizing germs (84% vs. 29%, p < 0.001, OR 12.9), longer ICU length of stay (LOS) (43 vs. 24 days, p = 0.002), MV (50 vs. 22 days, p < 0.001) and ECMO (28 vs. 12 days, p < 0.001), but did not have higher risk of death (survival rate 58% vs. 67%, p = 0.480, OR 0.68). Infected patients had almost halved ICU survival (46% vs. 78%, p < 0.001, OR 4.11).
conclusionsIn patients undergoing ECMO for respiratory and/or circulatory failure, colonization by MDR G- bacteria is frequent and associated with more the tenfold odds for subsequent infection. Those infections are associated with an increased risk of death.
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