Table 3 Clinical characteristics and outcomes of the 11 cases of Candida BSI and 83 cases of bacteremia during venoarterial extracorporeal membrane oxygenation (VA ECMO).

From: Different characteristics of bloodstream infection during venoarterial and venovenous extracorporeal membrane oxygenation in adult patients

Variables

Candida BSI (n = 11)

Bacteremia

P value* (Candida BSI vs. Gram- negative bacteremia

P value* (Candida BSI vs. Gram-positive bacteremia

Gram-negative bacteremia (n = 58)

Gram-positive bacteremia (n = 25)

Age, median years (IQR)

63 (54–68)

56 (45–68)

59 (45–66)

0.44

0.46

Male

5 (46)

44 (76)

20 (80)

0.042

0.038

ICU days before ECMO implantation, median (IQR)

1 (1–2)

0 (0–2)

0 (0–2)

0.11

0.13

Time between ECMO implantation and BSI, median days (IQR)

14 (8–35)

12 (7–18)

13 (6–19)

0.29

0.48

Duration of ECMO, median days (IQR)

23 (14–42)

17 (12–23)

20 (15–30)

0.08

0.50

ECPR

1 (9)

13 (22)

10 (40)

0.44

0.12

Immunocompromised state

4 (36)

34 (59)

17 (68)

0.20

0.14

Hematological malignancy

0

1 (2)

1 (4)

 > 0.99

 > 0.99

Active solid tumor

0

1 (2)

0

 > 0.99

N/A

Solid-organ transplant

1 (9)

2 (3)

2 (8)

0.41

 > 0.99

Long-term corticosteroid use

0

1 (2)

0

 > 0.99

N/A

High-dose corticosteroid use

4 (36)

31 (53)

17 (68)

0.34

0.14

SAPS III at ICU admission

57 (44–64)

53 (37–65)

49 (42–60)

0.39

0.42

SOFA at the time of BSI

12 (8–15)

13 (11–14)

11 (9–13)

0.60

0.69

SAPS II at the time of BSI

53 (49–67)

64 (53–81)

62 (51–73)

0.17

0.64

Inflammatory markers on the day of BSI

Lactate, mmol/L

3.5 (2.9–13.7)

5.0 (2.9–9.8)

4.3 (2.5–5.6)

0.57

0.89

CRP, mg/dL

11.4 (6.4–25.0)

13.9 (5.4–30.0)

13.0 (8.0–24.1)

0.41

0.66

Procalcitonin, ng/mL

2.4 (1.5–7.9)

5.0 (1.3–19.3)

5.5 (1.8–15.9)

0.23

0.29

CRRT prior to BSI

10 (91)

44 (76)

19 (76)

0.43

0.40

TPN prior to BSI

8 (73)

30 (52)

18 (72)

0.32

 > 0.99

Total antibiotic treatment duration before BSI, median days (IQR)a

20 (9–41)

14 (8–27)

13 (9–23)

0.21

0.31

Antibiotic exposure prior to BSIb

Glycopeptide

8 (73)

34 (59)

14 (56)

0.51

0.47

Carbapenem

9 (82)

20 (35)

10 (40)

0.006

0.03

Piperacillin/tazobactam

3 (27)

31 (53)

13 (52)

0.19

0.28

Amikacin

2 (18)

5 (9)

5 (20)

0.31

 > 0.99

Fluoroquinolones

6 (55)

17 (29)

8 (32)

0.10

0.20

Colistin

7 (64)

20 (35)

12 (48)

0.10

0.48

Metronidazole

2 (18)

11 (19)

2 (8)

 > 0.99

0.57

Antifungal agent

1 (9)

6 (10

2 (8)

 > 0.99

 > 0.99

Outcomes

ECMO weaning

2 (18)

18 (31)

6 (24)

0.49

 > 0.99

Survival to dischargec

1/3 (33)

8/48 (17)

4/13 (31)

0.43

0.68

  1. BSI, bloodstream infection; CRP, C-reactive protein; CRRT, continuous renal replacement therapy; ECPR, extracorporeal cardiopulmonary resuscitation; ICU, intensive care unit; IQR, interquartile range; SAPS, Simplified Acute Physiology Score; SOFA, sequential organ failure assessment; TPN, total parenteral nutrition.
  2. *P values with significant difference are indicated in bold.
  3. Data are presented as No. (%) unless indicated otherwise.
  4. aTotal antibiotic treatment duration between hospital admission and BSI development.
  5. b > 48 h of therapy within the 14 days prior to the BSI.
  6. c > Overall survival rates evaluated in patient-based, not episode-based.
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