title: Driveline infections in patients supported with a HeartMate II: incidence, aetiology and outcome.
abstract: OBJECTIVE
  To investigate the incidence and outcome of driveline infections in patients supported with a continuous flow left ventricular assist device (HeartMate II (HMII)) and to study the microbiological aetiology.
  
  
  METHODS
  Retrospective analysis of 31 patients who received an implantation of a HMII. Follow-up was from implantation to either device explantation, death or closure of the study. Clinical signs of infections were divided into superficial, deep or systemic and compared to culture and gram stain, the clinical course and infectious parameters.
  
  
  RESULTS
  The incidence of driveline infections was 1.65 episodes per patient per year. Staphylococcus aureus and Escherichia coli were the most common bacterial aetiology. More than two weeks of treatment was required in 81% of the patients. In terms of detecting superficial driveline infections, leucocyte count demonstrated a sensitivity of 27% and C-reactive protein (CRP) a sensitivity of 28%. In 22 cases of driveline infections plasma pro-calcitonin was found to be normal.
  
  
  CONCLUSIONS
  Driveline infections are common in HMII recipients but primarily remain superficial and are reasonably easy to manage. Infectious agents mostly originate from the skin and gastrointestinal tract. Blood biomarkers did not appear to be helpful in detecting driveline infections.
authors.affiliation: Rigshospitalet, Department of Cardiology, University Hospital of Copenhagen, Denmark.
authors.forename: Tobias
authors.initials: T
authors.lastname: Bomholt
authors.forename: Claus
authors.initials: C
authors.lastname: Moser
authors.forename: Kaare
authors.initials: K
authors.lastname: Sander
authors.forename: Søren
authors.initials: S
authors.lastname: Boesgaard
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.forename: Peter Skov
authors.initials: PS
authors.lastname: Olsen
authors.forename: Peter Bo
authors.initials: PB
authors.lastname: Hansen
authors.forename: Svend-Aage
authors.initials: SA
authors.lastname: Mortensen
authors.forename: Finn
authors.initials: F
authors.lastname: Gustafsson
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D016009:Chi-Square Distribution; D003718:Denmark / Q000453:epidemiology; D004926:Escherichia coli / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000097:blood / Q000453:epidemiology* / Q000382:microbiology* / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013203:Staphylococcal Infections / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers; D002097:C-Reactive Protein