title: Infection management in a patient with a left ventricular assist device: a case report of long-term cefazolin sodium hydrate administration.
abstract: A 55-year-old woman suffered from a bloodstream infection (Staphylococcus aureus), which originated from pump inflow and outflow skin exits, from 4 months after a parocorporeal left ventricular assist device (LVAD) had been implanted. In addition to local irrigation, repeated administration of a weekly unit of cefazolin hydrate was temporarily effective, but fever frequently recurred. Because short-term antibiotic administration had limited effectiveness, a much longer-term course of cefazolin was begun at 14 months post-LVAD implantation and was planned to continue until future transplantation. Unfortunately, the patient died from a cerebral embolism at 19 months after LVAD implantation; long-term consecutive cefazolin administration had suppressed the infection for over 5 months without side effects. To treat intractable LVAD-associated bloodstream infection, long-term administration of a narrow-spectrum beta-lactam drug is an effective option.
authors.affiliation: Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan. eiki@med.kurume-u.ac.jp
authors.forename: Eiki
authors.initials: E
authors.lastname: Tayama
authors.forename: Koichi
authors.initials: K
authors.lastname: Arinaga
authors.forename: Takahiro
authors.initials: T
authors.lastname: Shojima
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Takagi
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Yokokura
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yoshikawa
authors.forename: Hidetsugu
authors.initials: H
authors.lastname: Hori
authors.forename: Shuji
authors.initials: S
authors.lastname: Fukunaga
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Akashi
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Aoyagi
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000628:therapy*; D002437:Cefazolin / Q000008:administration & dosage*; D005260:Female; D006353:Heart-Assist Devices; D006801:Humans; D017053:Infection Control; D008875:Middle Aged; D018805:Sepsis / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D002437:Cefazolin