心室補助器官感染症の将来性,多センター研究
Rachel J Gordon1, Alan D Weinberg, Francis D Pagani
1Departments of Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA. rj216@columbia.edu
Circulation
|January 15, 2013
まとめ
静脈補助器官 (VAD) 感染症は,特にドライブラインで一般的であり,死亡率を増加させます. うつ病と腎臓機能不全は,VAD感染の主要な危険因子です.
科学分野:
- 心臓病学 心臓病学
- 感染症 感染症は感染症です.
- 医療機器 医療機器について
背景:
- 静脈補助器 (VAD) は,進行性心不全の生存率を高めますが,感染症に罹患する傾向があります.
- VAD関連の感染症の微生物学と疫学に関するデータは限られている.
- この研究は,VAD感染の疫学における知識のギャップを解決します.
研究 の 目的:
- VAD関連の感染症の発生率,微生物学,および危険因子を調査する.
- VAD感染の予測要因と患者のアウトカムへの影響を特定する.
- 感染率における新しいVADデバイスの役割を評価する.
主な方法:
- VADインプラント (2006年~2008年) を受けている150人の患者の将来的なマルチセンター登録.
- 1年間または移植,回復,または死亡までフォローアップ.
- 感染症の危険因子,臨床,検査,微生物学的データに関するデータ収集.
主要な成果:
- 患者の22%がVAD感染を発症した (33人の患者で34件の感染),発生率は100人/日あたり0.10であった.
- ドライブライン感染症が最も一般的であった (n=28),64%が侵襲性疾患を伴う.
- スタフィロコーシ (47%) とグラム陰性細菌 (32%) が主要な病原体であり,うつ病とクレアチニンの上昇が感染を予測した.
- VAD感染は1年間の死亡率を大幅に増加させた (aHR=5.6).
結論:
- 感染症は,より新しいデバイスでも,VADインプラントの頻繁な合併症です.
- うつ病や腎機能不全などの患者の要因は,VAD感染の重要なリスク要因です.
- VAD感染症は患者の生存に深刻な脅威をもたらし,慎重に管理する必要があります.
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