Cardiovascular device infections due to rapidly growing Mycobacteria: A review of cases at a tertiary care hospital

Abstract

Cardiovascular device infection due to rapidly growing mycobacteria (RGM) is rarely encountered in clinical practice. Due to the increasing number of indications and use of cardiovascular devices in an aging population, optimized management of these infections is of great importance. We report seven cases of RGM cardiovascular device infection. Three patients had left-ventricular assist device (LVAD) infections; two patients had cardiovascular implantable device (CIED) infections; and one had an aortic vascular stent infection. Specific cardiac valvular infection was not detected among any of the patients. All patients had a high number of comorbidities which limited some patients from receiving optimal combination antimicrobial therapy. The prognosis of cardiovascular device infections with RGM is guarded with only four patients still alive; however, the treatment approach for each patient varied considerably and often based on concurrent medical conditions, overall adjustments to goals of care, and specific patient preferences. Further analysis of cardiovascular device infections with RGM is warranted to establish a more systematic approach in successful management.

Skin and soft tissue infections due to rapidly growing mycobacteria

“…In the context of SSTIs, the main types of infections involve sternal wound infections following heart surgery, prothesis and surrounding soft tissue infections after hip and knee replacement surgery [33], even if any surgical wound can be potentially affected, as outlined by the recently reported pacemaker pocket infections due to M. abscessus and M. fortuitum and the intra-abdominal and surgical site abscesses following renal transplant surgery due to M. abscessus and M. chelonae (Fig. 2) [34][35][36]. Recently, an outbreak of invasive extrapulmonary infections by M. abscessus complex following heart surgery has been described in North Carolina, with 38 cases over a period of 4 years, 10 of which with extrapulmonary presentation with 40% of attributable mortality (Fig.…”

Strategies for surface coatings of implantable cardiac medical devices

“…However, infections with the following species have also been reported: Corynebacterium spp, Propionibacterium spp, Enterobacteriaceae species, Pseudomonas spp., Candida albicans , Mycobacterium abscessus and Aspergillus fumigatus ( Alessandro et al, 2004 ; Bongiorni et al, 2012 ). Infections predispose the patient to complicated surgical interventions or abrasive treatments with antibiotics ( Comba et al, 2022 ). Due to this, the need arises to formulate biocompatibility strategies, including the ability to avoid infections by pathogenic agents.…”