Cardiovascular Implantable Device Infections

Abstract

As life expectancy continues to increase and biotechnology advances, the use of cardiovascular implantable devices will continue to rise. Unfortunately, despite modern medical advances, the infection and mortality rates remain excessively elevated. This article reviews the pathophysiology and general concepts of cardiac device-related infections, including the physical and chemical characteristics of the medical device, host response to the medical device, and the microbiologic virulence factors. Infections of the most commonly utilized cardiovascular implantable devices, including cardiovascular implantable electronic devices, bioprosthetic and mechanical valves, ventricular assist devices, total artificial hearts, and coronary artery stents, are reviewed in detail.

In Vitro Assessment of Electric Currents Increasing the Effectiveness of Vancomycin Against Staphylococcus epidermidis Biofilms

“…Implant-based infections are a growing problem in healthcare as their incidence continues to rise while there is a lack of effective treatment options available for patients. S. epidermidis is a highly resistant strain and one of the most common associated with implant-based infections (28)(29)(30). In the current study, we have demonstrated that electric current (333 lA) increased the effectiveness of 16 lg/mL of vancomycin by reducing the number of viable cells in 48-h-old S. epidermidis biofilms.…”

Recent Nanotechnology Approaches for Prevention and Treatment of Biofilm-Associated Infections on Medical Devices

“…Contact with contaminated surfaces or infection by air-borne bacteria or fungal spores places surgical patients at risk [60, 61]. In fact, more than 60% of hospital related complications and up to 80% of infection associated deaths are attributable to biofilm infections [62, 63], and nearly 80% of known pathogenic bacteria have been implicated in device-related infections [64, 65], such as intravenous and urinary catheters [66], joint prostheses [67, 68], penile prostheses [69], contact lenses [70], fracture fixation devices [71, 72], breast implants [73, 74], pacemakers [75], endoscopes [76], cardiovascular and biliary stents [77], and coherent implants [78, 79]. Biofilms on these devices transmit bacteria and act as source of infection.…”

“…S. aureus , S. epidermidis , P. aeruginosa , Acinetobacter baumannii , Klebsiella pneumonia , E. coli , and P. acnes are reportedly the most common causative agents of cardiac implant infections [75] on pacemakers, prosthetic valves, defibrillators, and coronary artery bypass grafts, which incidentally grow thicker biofilms in vivo than in vitro [75, 78, 95]. Other microbes, such as Enterococcus and yeasts, also form biofilms on cardiovascular devices [96].…”

The Role of Bacterial Biofilms in Device-Associated Infection

“…45 Both enrichment culture and sonication have yielded skin commensals such as Staphylococcus aureus, S. epidermidis, and P. acnes. The incidence of clinical infection in these devices is increasing, most likely because of the complexity of the procedures involved and the associated comorbidities in the patient population receiving these prostheses.…”