Prospective, multicenter study of ventricular assist device infections

Area of Science:

• Cardiology
• Infectious Diseases
• Medical Devices

Background:

• Ventricular assist devices (VADs) enhance survival in advanced heart failure but are prone to infection.
• Limited data exist on the microbiology and epidemiology of VAD-related infections.
• This study addresses the knowledge gap in VAD infection epidemiology.

Purpose of the Study:

• To investigate the incidence, microbiology, and risk factors of VAD-related infections.
• To identify predictors of VAD infection and its impact on patient outcomes.
• To evaluate the role of newer VAD devices in infection rates.

Main Methods:

• Prospective, multicenter enrollment of 150 patients undergoing VAD implantation (2006-2008).
• Follow-up for 1 year or until transplantation, recovery, or death.
• Data collection on risk factors, clinical, laboratory, and microbiological data for infections.

Main Results:

• 22% of patients developed VAD infections (34 infections in 33 patients) with an incidence of 0.10 per 100 person-days.
• Driveline infections were most common (n=28), with 64% involving invasive disease.
• Staphylococci (47%) and Gram-negative bacteria (32%) were primary pathogens; depression and elevated creatinine predicted infection.
• VAD infection significantly increased 1-year mortality (aHR=5.6).

Conclusions:

• Infection remains a frequent complication of VAD implantation, even with newer devices.
• Patient factors like depression and renal dysfunction are significant risk factors for VAD infection.
• VAD infections pose a serious threat to patient survival and require careful management.