Evaluation of LVAD infections in a tertiary university hospital cohort

Abstract

AIM: This study aims to evaluate driveline infections in ourcenter in terms of pathogens and resistance patterns. BACKGROUND: The use of left ventricular assist devices (LVAD) is increasing for bridging therapy inpatients who cannot undergo heart transplantation or for long-term therapy in patients who are not suitable for heart transplantation. The most common complication after LVAD implantation is driveline infections. METHODS: We retrospectively evaluated LVAD patients implanted at our center between 01.01.2010 and 20.11.2023. Patients with drive-line infection findings and microbiological growth in the drive-line exit site culture were included in the study. Microbiological culture wgrowths, bacteremia rates, and resistance patterns of pathogens were evaluated. RESULTS: LVAD implantation was performed in 124 patients between the specified dates. In 109 patients [21 women (19.2%), mean age 50.9±12.45, years ranging 18-71], culture growth, which can be associated with LVAD,was observed in the drive-line exit site (n:94-86.2%), peripheral blood culture (55-50.4%), or both (52-47.7%). In 57 (52.2%) patients,multiple microorganisms were grown in the culture of the driveline exit area.In 15 (13.7%) patients, multiple microorganisms were grown in the peripheral blood cultures. The microorganisms are shown in Table 1.Etiological agents and resistance patterns of the microorganisms are shown in Table 2. During the follow-up period, the swab culture growths of 52 patients and the peripheral blood culture of 41 patients were eradicated. The five-year survival rate after LVAD implantation was 58/109(53.2%). CONCLUSIONS: LVAD-associated infections and antibiotic-resistant microorganisms are common in LVAD-implanted patients. When choosing antibiotics for LVAD-related infections, it is important to consider local hospital information.

Keywords

• Left Ventricular Assist Device
• Heart Failure
• Driveline Infections