Nosocomial infections in left ventricular assist device recipients.
Infection remains a serious complication of left ventricular assist device (LVAD) implantation. We performed a cohort study to assess infections among patients who underwent LVAD implantation from October 1996 through May 1999. Thirty-six LVADs were implanted in 35 patients; the mean duration (+/- standard deviation) of LVAD use was 73+/-60 days (total for all patients, 2565 days). Sixteen patients developed surgical site infections (SSIs; rate, 6.2 infections per 1000 LVAD days); 9 were deep-tissue or organ/space infections and 7 were superficial. Other infections included 7 cases of pneumonia (rate, 2.7 cases per 1000 LVAD days), 6 venous infections (rate, 2.3 per 1000 LVAD days), 2 bloodstream infections (rate, cases 0.8 per 1000 LVAD days), 3 urinary tract infections, and 2 skin and soft-tissue infections. Deep SSIs were associated with the requirement for postoperative hemodialysis (P=.02). Overall use of antibiotics was extensive, and a trend toward infection with antibiotic-resistant organisms was noted. Infections were a frequent complication of LVAD implantation. Further studies of interventions for preventing infection in LVAD recipients are warranted.
Malani
Preeti N
PN
Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Health System, Ann Arbor, MI, 48109, USA. pmalani@umich.edu
Dyke
David B S
DB
Pagani
Francis D
FD
Chenoweth
Carol E
CE
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002176:Candida albicans; D015331:Cohort Studies; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D016984:Enterococcus faecium; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D019919:Prosthesis Implantation / Q000009:adverse effects*; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D012307:Risk Factors; D013210:Staphylococcus; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D014640:Vancomycin