Microbiological findings in a cohort of patients with coronavirus disease 2019 and venovenous extracorporeal membrane oxygenation.

Background: Venovenous extracorporeal membrane oxygenation (VV ECMO) is an established support option for patients with very severe respiratory failure and played an important role during the coronavirus disease 2019 (COVID-19) pandemic. Bacteria and fungi can lead to severe infectious complications in critically ill patients. The aim of this study was to describe the microbiological spectrum of bacteria and fungi detected in patients with COVID-19-associated respiratory failure supported with VV ECMO in our center.
Methods: This retrospective single-center analysis included all patients with COVID-19-associated respiratory failure supported with VV ECMO in our center between March 2020 and May 2022. All findings from microbiological samples, taken as part of clinical routine assessment from initiation of VV ECMO until day 30 were included. Samples were described by site and time of detection and microbiological characteristics.
Results: From March 2020 through May 2022, 88 patients with COVID-19-associated respiratory failure received VV ECMO support at our center. In 83/88 patients (94.3%), one or more pathogens were found in microbiological samples. Most pathogens were isolated from samples from the respiratory tract (88.6%). Earliest detection occurred in samples from the respiratory tract with a median time of 5 days to first detection. The most frequently detected pathogens were Staphylococcus spp., Candida spp., Klebsiella spp., Escherichia coli and Enterococcus spp.
Conclusion: In this cohort of severely ill COVID-19 patients receiving VV ECMO support, pathogens were frequently detected.
Competing Interests: Declarations. Conflict of interest: All authors have completed the ICMJE form (available upon request from the corresponding author). D.L. Staudacher received honoraria for lecturing Abiomed, AstraZeneca, Getinge, Medtronic, Dahlhausen and Orion Pharma, all of which are unrelated to this manuscript. T. Wengenmayer reports lecture fees from Getinge and Resuscitec. A. Supady reports research grants and lecture fees from CytoSorbents, lecture fees from Getinge, Resuscitec, AstraZeneca and Abiomed and travel support and consulting fees from ARTCLINE, all outside the submitted work. A. Supady is member of the scientific committee of EuroELSO. C. Glück, E. Widmeier and S. Maier declare that they have no competing interests. Data collection was approved by the institutional ethics committee of the University of Freiburg (EK 151/14); due to the retrospective and observational nature of the study, the need for informed consent was waived.
(© 2025. The Author(s).)