Postcardiac Surgery Infections

Lutwick, Larry I.; Vaghjimal, A.; Connolly, Mark W.

doi:10.1016/s0749-0704(05)70393-6

Cited by 26 publications

(7 citation statements)

References 108 publications

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“…Many comorbidities have been identified as favoring postoperative infections in cardiac surgery patients, including diabetes, obesity, and chronic obstructive airway disease [14][15][16]. Our study did not find any significant difference between infected and uninfected patients for these variables, probably because of the small sample size.…”

Section: Discussioncontrasting

confidence: 76%

Nosocomial Infections Occurring during Receipt of Circulatory Support with the Paracorporeal Ventricular Assist System

Mekontso-Dessap¹,

Kirsch

Vermès

et al. 2002

CLIN INFECT DIS

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This retrospective study sought to report the spectrum of infections in a homogenous group of 39 patients who underwent implantation of the Thoratec paracorporeal ventricular assist device system (Thoratec Laboratories) in an emergency setting. Thirty-one of the 39 patients developed a total of 99 nosocomial infections (attack rate, 79.5%; incidence, 4.9 per 100 support-days). The lungs were the most frequently involved site (31.3%), and coagulase-negative Staphylococcus species were the pathogens most frequently isolated (16.2%). Infected patients required more transfusions and chest surgical revisions, as well as a longer duration of mechanical ventilation and a longer stay in the intensive care unit, compared with uninfected patients. Cox regression analysis revealed that chest surgical revision was the only independent risk factor for infection at any site (odds ratio, 2.6; 95% confidence interval, 1.2-5.7). There was no significant effect of infection on heart transplantation rate and overall survival.

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Section: Discussioncontrasting

confidence: 76%

Nosocomial Infections Occurring during Receipt of Circulatory Support with the Paracorporeal Ventricular Assist System

Mekontso-Dessap¹,

Kirsch

Vermès

et al. 2002

CLIN INFECT DIS

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“…The sanguis streptococci and related organisms are also a common cause of native heart valve (18,42) and late prosthetic valve (28) endocarditis. Not all bacteria are capable of causing endocarditis, but these bacteria appear to have specific properties that enable them to colonize a modified valve surface (1,12,24,27).…”

mentioning

confidence: 99%

Streptococcus parasanguis Fimbria-Associated Adhesin Fap1 Is Required for Biofilm Formation

2001

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The sanguis streptococci are primary colonizers of the tooth surface and thus form the foundation for the complex multiple species biofilm known as dental plaque. In addition, these bacteria can colonize native and prosthetic heart valves and are a common cause of endocarditis. Little is known about the molecular mechanisms governing multiple or single species biofilm development within this group of organisms. Using an in vitro assay for biofilm formation, we determined that (i) Streptococcus parasanguis FW213 can form biofilms on inert surfaces such as polystyrene and (ii) environmental and nutritional factors, such as glucose, affect S. parasanguis biofilm formation. Several isogenic mutants of FW213 were tested in the biofilm assay. Strains containing mutations in fap1, a gene encoding a protein required for assembly of fimbriae, were deficient in biofilm formation. Mutants defective in recA, PepO endopeptidase activity, or the production of a fimbriaeassociated protein, FimA, were still capable of biofilm formation. Phase-contrast microscopy was used to follow biofilm development by wild-type and fap1 mutant strains on plastic coverslips over time. Wild-type FW213 attached to the surface, formed aggregates of cells, and eventually formed a dense layer of cells that included microcolonies. In contrast, few fap1 mutant cells were observed attached to the surface, and no cell aggregates or microcolonies were formed. These results suggest that the long peritrichous fimbriae of FW213 are critical for the formation of biofilms on solid surfaces.

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“…The leading causes of death in 'early' prosthetic valve endocarditis are septic shock (36%), congestive heart failure (29%) and renal failure (21%) 21 . Both the patients reported here had 'early' prosthetic valve endocarditis and subsequently died of septic shock.…”

Section: Discussionmentioning

confidence: 99%