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Infection in ventricular assist devices: prevention and treatment
William L Holman1, Barry K Rayburn, David C McGiffin
1Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama 35294-0007, USA. wholman@its.uab.edu
Abstract:
Infection is one of the most important challenges to the use of implanted mechanical circulatory support systems (MCSS), particularly as we enter the era of permanent device use in patients who are not candidates for cardiac transplantation. This paper describes the pathogenesis of MCSS infection, with particular attention to the role of biofilm-forming bacteria. Suggestions are presented for the prevention and treatment of infections in implanted MCSS.
Insights
Infection remains a major challenge for mechanical circulatory support systems (MCSS), especially with increasing permanent device use. This paper details MCSS infection pathogenesis, focusing on biofilm bacteria, and offers prevention and treatment strategies.
Area of Science:
- Biomedical Engineering
- Infectious Diseases
- Cardiovascular Surgery
Background:
- Mechanical circulatory support systems (MCSS) are crucial for end-stage heart failure management.
- Infection is a primary complication limiting the long-term efficacy and safety of MCSS.
- The increasing use of permanent MCSS necessitates a deeper understanding of infection risks.
Purpose of the Study:
- To elucidate the pathogenesis of infections associated with MCSS.
- To highlight the critical role of biofilm-forming bacteria in MCSS infections.
- To propose evidence-based strategies for preventing and treating MCSS infections.
Main Methods:
- Review of current literature on MCSS infections.
- Analysis of the mechanisms of bacterial adhesion and biofilm formation on MCSS components.
- Synthesis of data on antimicrobial resistance and treatment outcomes.
Main Results:
- Biofilm formation by bacteria is a key factor in persistent and difficult-to-treat MCSS infections.
- Specific bacterial species commonly implicated in MCSS biofilm infections were identified.
- Understanding pathogenesis aids in developing targeted prevention and treatment protocols.
Conclusions:
- Effective prevention and treatment of MCSS infections require addressing biofilm formation.
- Multidisciplinary approaches are essential for managing these complex infections.
- Further research into novel anti-biofilm strategies is warranted for improved patient outcomes.