Staphylococcal driveline infections are the predominant type of left ventricular assist device associated infections in Singapore.

Authors:
Yii Ean Teh
Yii Ean Teh
11 Hospital Drive
Singapore
Choon Pin Lim
Choon Pin Lim
aNational Heart Centre Singapore bDuke NUS Graduate Medical School
Singapore
Jia Lin Soon
Jia Lin Soon
St. Paul's Hospital
Canada
Chia Lee Neo
Chia Lee Neo
Department of Cardiology
Kolkata | India

Infect Dis (Lond) 2019 Jun 15;51(6):417-424. Epub 2019 Apr 15.

a Department of Infectious Diseases , Singapore General Hospital , Singapore.

Background: Left ventricular assist device (LVAD) associated infections (LVADIs) have substantial morbidity and mortality. We aim to describe the incidence and epidemiology of LVADIs in an Asian cohort. This is currently not well studied.

Methods: We conducted a retrospective review of 52 patients who underwent LVAD implantation from 1 May 2009-31 December 2014 in National Heart Centre Singapore. LVADIs were defined based on definitions proposed by the International Society for Heart and Lung Transplantation.

Results: There were 39 males and 13 females. Seventy-three percent had Heartmate II LVAD implant while 27% received Heartware HVAD. Eighty-one percent were implanted as bridge to heart transplantation, 19% as destination therapy. Forty-five episodes of LVADIs occurred in 25 patients. Overall LVADI incidence was 47.5 cases per 100 patient-years. Driveline infections (58%) were the commonest type of LVADI. The commonest causative organisms were coagulase-negative staphylococci (33%), Staphylococcus aureus (31%) and Corynebacterium species (19%). Twelve percent of patients with LVADI required surgical debridement and one patient required pump exchange due to pump pocket infection. All-cause mortality was 13%.

Conclusions: The findings of our study add to the understanding and epidemiology of LVADIs, particularly in the Asian setting. This can contribute to the development of evidence based strategies to prevent and manage LVADIs.

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Source
http://dx.doi.org/10.1080/23744235.2019.1592216DOI Listing
June 2019
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References

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