• S E Coffin, L M Bell, M Manning, and R Polin.
• Division of Immunologic and Infectious Diseases, Children's Hospital of Philadelphia, PA 19104, USA.
• Infect Control Hosp Epidemiol. 1997 Feb 1; 18 (2): 93-6.

ObjectiveTo determine the incidence of, and risk factors for, nosocomial infections in neonates during and after treatment with extracorporeal membrane oxygenation (ECMO).DesignA retrospective cohort study of all infants treated with ECMO during a 4-year period.Patients26 neonates experiencing 32 nosocomial infections, and 54 neonates with no nosocomial infections.SettingA large, urban children's hospital.Results30% of neonates treated with ECMO experienced at least one nosocomial infection. The rate of nosocomial infections was 10.3 per 1,000 patient-days. Risk factors significantly associated with nosocomial infection included duration of ECMO > 7 days (mean, 12 vs 7 days; odds ratio [OR], 2.84; 95% confidence interval [CI95], 0.96-8.56); neonatal intensive care-unit stay > 21 days (mean, 44 vs 19 days; OR, 8.73; CI95, 2.49-31.94); hospitalization > 50 days (mean, 63 vs 29 days; OR, 5.44; CI95, 1.47-20.87); and surgical procedure before or during ECMO (46% vs 22%; OR, 4.58 CI95, 1.25 to 17.38).ConclusionsNosocomial infections occurred in 30% of patients undergoing ECMO. Although nosocomial infections were not associated with an increase in mortality, hospitalization was prolonged.

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