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Colonization With Multiresistant Bacteria: Impact on Ventricular Assist Device Patients
Maria Papathanasiou1, Julia Pohl1, Rolf Alexander Jánosi1
1Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany.
The Annals of Thoracic Surgery
|November 28, 2017
Summary
Multidrug-resistant bacteria (MDRB) colonization significantly increases infection-related death risk in left ventricular assist device (LVAD) recipients. Pre- and post-implantation screening for MDRB is crucial for preventing complications in these vulnerable patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Microbiology
Background:
- The impact of multidrug-resistant bacteria (MDRB) infections in left ventricular assist device (LVAD) recipients is known.
- However, the role of perioperative colonization in the development of these infections is unclear.
- This study investigates the association between MDRB colonization and patient outcomes post-LVAD implantation.
Purpose of the Study:
- To evaluate the effect of MDRB colonization on patient outcomes after LVAD implantation.
- To determine if perioperative MDRB colonization is a risk factor for infection and mortality in LVAD recipients.
Main Methods:
- Retrospective analysis of microbiological screening data (nasal, throat, wound, rectal swabs) from 82 LVAD patients (2010-2015).
- Defined MDRB categories including methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and resistant Gram-negative bacteria.
- Compared long-term outcomes between colonized and non-colonized patients.
Main Results:
- 34.1% of patients were colonized with at least one MDRB species.
- MDRB colonization was linked to higher rates of fatal infections (any pathogen and MDRB-specific).
- Colonized patients experienced significantly longer intensive care unit and hospital stays.
Conclusions:
- MDRB colonization is a prevalent risk factor for infection-associated mortality in LVAD patients.
- Routine MDRB screening before and after LVAD implantation is recommended.
- Screening can identify high-risk individuals and guide preventative strategies for infectious complications.
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