Anaerobic Bacteremias in Left Ventricular Assist Devices and Advanced Heart Failure
Autor: | Daniel B Chastain, Natalia C Pinto, Gabriel Motoa, Esther Benamu, Carlos Franco-Paredes, David R. Murillo-García, Andrés F. Henao-Martínez, Julian Galindo |
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Rok vydání: | 2019 |
Předmět: |
medicine.medical_specialty
business.industry Mortality rate General Medicine 030204 cardiovascular system & hematology Aspiration pneumonia equipment and supplies medicine.disease lcsh:Infectious and parasitic diseases 03 medical and health sciences 0302 clinical medicine Quality of life Heart failure Bacteremia medicine Etiology Case Series lcsh:RC109-216 030212 general & internal medicine Intensive care medicine business Anaerobic exercise Destination therapy |
Zdroj: | Case Reports in Infectious Diseases, Vol 2019 (2019) Case Reports in Infectious Diseases |
ISSN: | 2090-6633 2090-6625 |
DOI: | 10.1155/2019/7571606 |
Popis: | 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. |
Databáze: | OpenAIRE |
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