Anaerobic Bacteremias in Left Ventricular Assist Devices and Advanced Heart Failure
Left ventricular assisted devices (LVADs) have revolutionized the treatment of advanced heart failure, providing meaningful increases in survival, functional capacity, and quality of life. There are two categories of LVADs patients: (1) bridge-to-transplant and (2) destination therapy. Advanced hear...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Infectious Diseases |
| Online Access: | http://dx.doi.org/10.1155/2019/7571606 |
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| author | David R. Murillo-Garcia Julian Galindo Natalia Pinto Gabriel Motoa Esther Benamu Carlos Franco-Paredes Daniel B. Chastain Andrés F. Henao-Martínez |
| author_facet | David R. Murillo-Garcia Julian Galindo Natalia Pinto Gabriel Motoa Esther Benamu Carlos Franco-Paredes Daniel B. Chastain Andrés F. Henao-Martínez |
| author_sort | David R. Murillo-Garcia |
| collection | DOAJ |
| description | Left ventricular assisted devices (LVADs) have revolutionized the treatment of advanced heart failure, providing meaningful increases in survival, functional capacity, and quality of life. There are two categories of LVADs patients: (1) bridge-to-transplant and (2) destination therapy. Advanced heart failure and destination LVADs often carry a poor prognosis. The overall 1-year mortality rate remains as high as 30%. LVAD-specific infections, LVAD-related infections, and non-LVAD-related infections represent important emerging clinical problems in this setting. With an incidence ranging from 30 to 50%, these lead to high rates of hospitalization, morbidity, and mortality. Bacteremias caused by anaerobic pathogens in patients with LVAD are underreported. Herein, we describe the microbiological findings, treatment, and clinical outcome of four patients with LVADs and advanced heart failure with anaerobic bacteremias. Fusobacterium species was the most frequent etiological agent. Most patients had a relatively favorable short-term outcome with survival rates of 100% at 30 days and of 50% at 90 days. However, due to other multiple long-term complications, overall mortality remains at 50% during the first year and increases to 75% beyond the first year. Anaerobic bacteremia sources included the oral cavity from odontogenic infections and aspiration pneumonia. Anaerobic bacteremia constitutes an unfavorable mortality prognostic factor in patients with destination LVADs. We recommend implementing preventive strategies with a comprehensive dental care evaluation in patients with LVADs and advanced heart failure. |
| format | Article |
| id | doaj-art-19051ea5c7c142a59c8592269b0f7fe0 |
| institution | Kabale University |
| issn | 2090-6625 2090-6633 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Infectious Diseases |
| spelling | doaj-art-19051ea5c7c142a59c8592269b0f7fe02025-02-03T01:29:17ZengWileyCase Reports in Infectious Diseases2090-66252090-66332019-01-01201910.1155/2019/75716067571606Anaerobic Bacteremias in Left Ventricular Assist Devices and Advanced Heart FailureDavid R. Murillo-Garcia0Julian Galindo1Natalia Pinto2Gabriel Motoa3Esther Benamu4Carlos Franco-Paredes5Daniel B. Chastain6Andrés F. Henao-Martínez7Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, ColombiaSchool of Medicine, Universidad Libre, Cali, ColombiaSchool of Medicine, Universidad Libre, Cali, ColombiaDivision of Infectious Diseases, University of Colorado Denver, Denver, CO, USADivision of Infectious Diseases, University of Colorado Denver, Denver, CO, USADivision of Infectious Diseases, University of Colorado Denver, Denver, CO, USAUniversity of Georgia College of Pharmacy, Athens, GA, USADivision of Infectious Diseases, University of Colorado Denver, Denver, CO, USALeft ventricular assisted devices (LVADs) have revolutionized the treatment of advanced heart failure, providing meaningful increases in survival, functional capacity, and quality of life. There are two categories of LVADs patients: (1) bridge-to-transplant and (2) destination therapy. Advanced heart failure and destination LVADs often carry a poor prognosis. The overall 1-year mortality rate remains as high as 30%. LVAD-specific infections, LVAD-related infections, and non-LVAD-related infections represent important emerging clinical problems in this setting. With an incidence ranging from 30 to 50%, these lead to high rates of hospitalization, morbidity, and mortality. Bacteremias caused by anaerobic pathogens in patients with LVAD are underreported. Herein, we describe the microbiological findings, treatment, and clinical outcome of four patients with LVADs and advanced heart failure with anaerobic bacteremias. Fusobacterium species was the most frequent etiological agent. Most patients had a relatively favorable short-term outcome with survival rates of 100% at 30 days and of 50% at 90 days. However, due to other multiple long-term complications, overall mortality remains at 50% during the first year and increases to 75% beyond the first year. Anaerobic bacteremia sources included the oral cavity from odontogenic infections and aspiration pneumonia. Anaerobic bacteremia constitutes an unfavorable mortality prognostic factor in patients with destination LVADs. We recommend implementing preventive strategies with a comprehensive dental care evaluation in patients with LVADs and advanced heart failure.http://dx.doi.org/10.1155/2019/7571606 |
| spellingShingle | David R. Murillo-Garcia Julian Galindo Natalia Pinto Gabriel Motoa Esther Benamu Carlos Franco-Paredes Daniel B. Chastain Andrés F. Henao-Martínez Anaerobic Bacteremias in Left Ventricular Assist Devices and Advanced Heart Failure Case Reports in Infectious Diseases |
| title | Anaerobic Bacteremias in Left Ventricular Assist Devices and Advanced Heart Failure |
| title_full | Anaerobic Bacteremias in Left Ventricular Assist Devices and Advanced Heart Failure |
| title_fullStr | Anaerobic Bacteremias in Left Ventricular Assist Devices and Advanced Heart Failure |
| title_full_unstemmed | Anaerobic Bacteremias in Left Ventricular Assist Devices and Advanced Heart Failure |
| title_short | Anaerobic Bacteremias in Left Ventricular Assist Devices and Advanced Heart Failure |
| title_sort | anaerobic bacteremias in left ventricular assist devices and advanced heart failure |
| url | http://dx.doi.org/10.1155/2019/7571606 |
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