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Characteristics and Outcomes of Candidemia in Patients with Durable Left Ventricular Assist Device Support

Kaitlyn L Broderick1, Carli J Peters1, Jeremy A Mazurek2

  • 1From the Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|December 30, 2021
PubMed

Insights

Fungal infections (fungemia) are rare but severe complications in patients with durable left ventricular assist devices (LVADs). This study found fungemia occurred early after LVAD implantation and was associated with serious neurological events.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Device Research

Background:

  • Limited data exist on fungal infections in patients with durable left ventricular assist device (LVAD) support.
  • Fungal infections (fungemia) can be a severe complication in immunocompromised patients and those with indwelling medical devices.

Purpose of the Study:

  • To characterize the epidemiology and clinical outcomes of fungemia in patients with LVAD support.
  • To identify risk factors and common pathogens associated with fungemia in this population.

Main Methods:

  • Retrospective review of patients with LVAD support from January 2012 to June 2020 at a large academic institution.
  • Analysis of patient demographics, clinical presentation, causative fungal species, treatment, and outcomes.

Main Results:

  • Fungemia occurred in 1.4% (5/336) of LVAD patients, diagnosed early post-implantation (mean 14.4 days).
  • Candida species were the causative agents, with most isolates susceptible to fluconazole.
  • Neurological complications, including stroke, were observed. Two patients were transplanted, and two remained on suppressive therapy.

Conclusions:

  • Fungemia is a rare, severe, and early complication in LVAD patients.
  • Prompt diagnosis and appropriate antifungal therapy are crucial for managing fungemia in LVAD recipients.

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