Retrospective ANalysis of multi-drug resistant Gram-nEgative bacteRia on veno-venous extracorporeal membrane oxygenation. The multicenter RANGER STUDY

• Published in: Critical care (London, England) England), 2024-08, Vol.28 (1), p.279, Article 279
• Main Authors: Boscolo, Annalisa, Bruni, Andrea, Giani, Marco, Garofalo, Eugenio, Sella, Nicolò, Pettenuzzo, Tommaso, Bombino, Michela, Palcani, Matteo, Rezoagli, Emanuele, Pozzi, Matteo, Falcioni, Elena, Pistollato, Elisa, Biamonte, Eugenio, Murgolo, Francesco, D'Arrigo, Graziella, Gori, Mercedes, Tripepi, Giovanni Luigi, Gottin, Leonardo, Longhini, Federico, Grasso, Salvatore, Navalesi, Paolo, Foti, Giuseppe
• Format: Article
• Language: English
• Subjects: Acute respiratory distress syndrome; Adult; Aged; Analysis; Antibiotics; Bacteria; Beta lactamases; Contraindications; Disease control; Drug resistance; Drug Resistance, Multiple, Bacterial; Extracorporeal membrane oxygenation; Extracorporeal Membrane Oxygenation - methods; Extracorporeal Membrane Oxygenation - statistics & numerical data; Extubation; Female; Gram-Negative Bacteria - drug effects; Gram-Negative Bacterial Infections - drug therapy; Gram-Negative Bacterial Infections - mortality; Health aspects; Hospital patients; Hospitals; Humans; Hypoxemia; Infectious diseases; Intensive care; Italy - epidemiology; Laboratories; Male; Medical research; Medicine, Experimental; Microbiology; Middle Aged; Mortality; Nosocomial infections; Pathogens; Patients; Respiratory agents; Retrospective Studies; Risk factors; Sepsis; Variables; Ventilators; Weaning
• ISSN: 1364-8535; 1466-609X; 1466-609X; 1364-8535; 1366-609X
• DOI: 10.1186/s13054-024-05068-x

Veno-venous extracorporeal membrane oxygenation (V-V ECMO) is a rapidly expanding life-support technique worldwide. The most common indications are severe hypoxemia and/or hypercapnia, unresponsive to conventional treatments, primarily in cases of acute respiratory distress syndrome. Concerning potential contraindications, there is no mention of microbiological history, especially related to multi-drug resistant (MDR) bacteria isolated before V-V ECMO placement. Our study aims to investigate: (i) the prevalence and incidence of MDR Gram-negative (GN) bacteria in a cohort of V-V ECMOs; (ii) the risk of 1-year mortality, especially in the case of predetected MDR GN bacteria; and (iii) the impact of annual hospital V-V ECMO volume on the probability of acquiring MDR GN bacteria. All consecutive adults admitted to the Intensive Care Units of 5 Italian university-affiliated hospitals and requiring V-V ECMO were screened. Exclusion criteria were age