Mycobacterium abscessus Infection in Left Ventricular Assist Device (LVAD): A Case Series

Hernandez, Jarelys M; Huff, Mallorie L; Nlandu, Zola; Vekariya, Bhavesh; Torres, J.P.

doi:10.7759/cureus.15718

Cited by 3 publications

(6 citation statements)

References 14 publications

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“…Of these, four were subsequently excluded because of either inclusion of mycobacterial species other than M. abscessus species (n = 1) 12 or lack of outcome data (n = 3). [13][14][15] Therefore, our search strategy identified three articles 1,3,8 describing a total of 17 patients who received omadacycline therapy for M. abscessus species infection. These cases, including our case report, are summarised in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…After exclusion of duplicates and screening of articles based on title and abstract, seven full‐text articles were deemed potentially relevant. Of these, four were subsequently excluded because of either inclusion of mycobacterial species other than M. abscessus species ( n = 1) 12 or lack of outcome data ( n = 3) 13–15 . Therefore, our search strategy identified three articles 1,3,8 describing a total of 17 patients who received omadacycline therapy for M. abscessus species infection.…”

Section: Resultsmentioning

confidence: 99%

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Omadacycline therapy for Mycobacterium abscessus species infections

Ingram

Jones

Allen

et al. 2023

Internal Medicine Journal

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BackgroundAntimicrobial resistance and therapy‐related adverse effects make Mycobacterium abscessus treatment challenging. Omadacycline is a novel, bioavailable aminomethylcycline with favourable in vitro activity against M. abscessus.AimsTo describe a case report and review the published literature describing outcomes for M. abscessus infections treated with omadacycline.MethodsSystematic literature review.ResultsWe identified three articles that, in addition to our case report, describe 18 patients. Pulmonary infections were most frequent. Minimum inhibitory concentrations were reported for two isolates (0.25 and 0.5 mg/L). Despite half the patients starting omadacycline because of failure of prior therapy, 15 (83%) had a favourable outcome, defined as ‘cure’, ‘improvement’ or ‘clinical success’ as determined by the primary study authors. One patient (6%) discontinued omadacycline because of gastrointestinal intolerance.ConclusionsAlthough the limited observational data and in vitro susceptibility results are encouraging, randomised control trials are required to determine the role of omadacycline as part of combination therapy for this most difficult‐to‐treat pathogen.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Omadacycline therapy for Mycobacterium abscessus species infections

Ingram

Jones

Allen

et al. 2023

Internal Medicine Journal

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“…All of them appeared in the literature during 2017-2022. [12][13][14][15] Wolfe et al identified all patients at a single center with VADs and positive cultures for M. abscessus between 2013 and 2015. 12 They reported invasive M. abscessus infections in 10 patients with VADs.…”

Section: Discussionmentioning

confidence: 99%

“…Health care–associated outbreaks caused by NTMs were reviewed in 2016–2017 4,5 . Since then, multiple nosocomial outbreaks of infections caused by NTM after cardiac surgery, heart transplantation, and LVAD placement have been described 6–15 . The researchers were able to trace outbreaks to contamination of water heating and cooling units.…”

mentioning

confidence: 99%

“…4,5 Since then, multiple nosocomial outbreaks of infections caused by NTM after cardiac surgery, heart transplantation, and LVAD placement have been described. [6][7][8][9][10][11][12][13][14][15] The researchers were able to trace outbreaks to contamination of water heating and cooling units. There are 2 well-described pediatric dental clinicassociated outbreaks of MABC infection.…”

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A Case-Based Review of LVAD Infection by MABC

Khardori,

Ripley,

Talt

et al. 2024

Infect Dis Clin Pract

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We present a review of literature and report a case of left ventricular assist device (LVAD) infection and postsurgical wound infection with Mycobacterium abscessus complex (MABC) following exposure to sewage and tap water, respectively. The initial infectious process involved the driveline and the deep pocket and progressed to involve LVAD. Prior to availability of culture results, the patient was started on linezolid followed by surgical debridement of driveline site and change of exit site. The debrided tissue grew a smooth and a rough colony variant of MABC. After 2 weeks of imipenem intravenous (IV), tigecycline IV, azithromycin oral (PO), and tedizolid PO, the patient presented to us with worsening of wound status. Antimicrobial therapy was changed to amikacin IV, imipenem IV, and cefoxitin IV along with bedside debridement, removal of 3 sutures, and placement of wound vacuum device. Amikacin IV, imipenem IV, and cefoxitin IV were then replaced with Recarbio (imipenem/cilastatin/relebactam) IV plus amoxicillin PO with significant improvement. The patient underwent LVAD removal and heart transplantation after 5 weeks and was discharged 15 days later. Following showering at home, the patient developed signs of extensive infection involving the surgical wound (chest and abdominal walls). Tigecycline IV and azithromycin IV were started. Imipenem/cilastatin/ relebactam IV plus amoxicillin PO were replaced by bedaquiline PO because of the continued financial burden to the patient. The patent was discharged on bedaquiline PO and azithromycin PO to complete 18 months of antimicrobial therapy at which time he was enjoying a very active lifestyle as he did prior to the diagnosis of advanced heart failure. He continues to do well 2 years 9 months after heart transplantation and more than a year after stopping all antimycobacterial therapy.

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

Comba

Chesdachai

Tabaja

et al. 2022

Journal of Clinical Tuberculosis and Other Mycobacterial Diseas

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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.

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Mycobacterium abscessus Infection in Left Ventricular Assist Device (LVAD): A Case Series

Cited by 3 publications

References 14 publications

Omadacycline therapy for Mycobacterium abscessus species infections

Omadacycline therapy for Mycobacterium abscessus species infections

A Case-Based Review of LVAD Infection by MABC

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

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