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Minimum inhibitory concentration changes in relapsed left ventricular assist device driveline infections

Tara H Lines1, Leah A Sabato1, Whitney J Nesbitt1

  • 1Department of Pharmacy, Nashville, TN, USA.

The International Journal of Artificial Organs
|January 23, 2020
PubMed

Insights

Minimum inhibitory concentration changes in relapsed driveline infections after left ventricular assist device implantation are variable. These changes did not always lead to resistance, suggesting other factors contribute to recurrent infections.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Device Technology

Background:

  • Driveline infection is a frequent complication in patients with left ventricular assist devices (LVADs).
  • Understanding minimum inhibitory concentration (MIC) changes in relapsed driveline infections is crucial for effective management.
  • Limited data exists on MIC variability in recurrent LVAD driveline infections.

Purpose of the Study:

  • To describe minimum inhibitory concentration (MIC) changes in patients with LVADs who experienced relapsed driveline infections.
  • To investigate the relationship between MIC changes and the development of resistance in relapsed infections.
  • To identify factors associated with relapsed driveline infections.

Main Methods:

  • Retrospective descriptive epidemiology study.
  • Analysis of patients with LVAD implantation between January 1, 2013, and August 1, 2017, who developed driveline infection with positive cultures.
  • Evaluation of MIC changes in relapsed driveline infections, particularly focusing on Staphylococcus aureus, Pseudomonas aeruginosa, and Mycobacterium fortuitum.

Main Results:

  • Out of 330 LVAD patients, 30 developed driveline infection, with 34 relapsed infections observed.
  • Staphylococcus aureus was the most common pathogen in both new and relapsed driveline infections.
  • Nine of 13 patients with relapsed infections showed MIC changes; these changes did not cause resistance in S. aureus but did in Pseudomonas aeruginosa and Mycobacterium fortuitum.

Conclusions:

  • Minimum inhibitory concentration (MIC) changes in relapsed driveline infections are variable and may not be the primary driver of recurrence in gram-positive infections.
  • Suppressive therapy may be associated with a longer time to first relapse.
  • Further research is needed to fully elucidate the mechanisms behind relapsed driveline infections in LVAD patients.
Keywords:
Cardiac assist & artificial heartdevice-related infectionsdriveline infectionpre-transplant infection

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