Antibiotic Treatment of Gram-Negative Bacterial Left Ventricular Assist Device Infections: A Systematic Review
- 1Thoraxcenter, Department of Cardiology, Cardiovascular Institute, Erasmus MC University Medical Center Rotterdam, 3015 GD Rotterdam, Netherlands
- 2Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Centre Rotterdam, 3015 GD Rotterdam, Netherlands
Abstract
Background:: Gram-negative bacterial left ventricular assist device (LVAD) infections pose significant challenges due to antimicrobial resistance and high relapse rates. Moreover, current standardized treatment guidelines remain limited. Thus, this study aimed to evaluate current antimicrobial strategies for Gram-negative bacterial LVAD infections, highlight treatment trends, and examine outcomes to inform clinical decision-making.
Methods:: A systematic review was conducted in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they reported antibiotic regimens for Gram-negative LVAD-specific infections and the clinical outcomes of these infections. Antibiotic regimens, associated management strategies, and clinical outcomes were summarized by infection location.
Results:: A total of 15 studies were included, reporting 25 cases of Gram-negative LVAD-specific infections and 28 identified Gram-negative pathogens. Most cases involved superficial or deep driveline/exit-site/pocket infections (16/25, 64.0%), whereas pump/cannula infections and device-specific bloodstream infections occurred in 3/25 (12.0%) and 6/25 (24.0%) patients, respectively. Antibiotic strategies varied widely in both selection and duration. Superficial driveline and exit-site infections were treated with a median of 14 days of antibiotics (interquartile range (IQR), 14–21.5; range, 7–49), whereas deep driveline/pocket infections required longer treatment with a median of 42 days (IQR, 31.5–42; range, 14–42). Pump/cannula and bloodstream infections often required prolonged therapy, suppressive treatment, and/or major surgical intervention.
Conclusions:: The treatment of Gram-negative bacterial LVAD infections remains highly variable and poorly characterized due to the limited number of reported cases, making it difficult to establish evidence-based clinical recommendations. This highlights the urgent need for further research to establish evidence-based treatment protocols and improve patient outcomes.
Related
- Bacterial profile and antibiotic susceptibility of bloodstream infections among infants, children, and adolescents undergoing treatment for acute leukemia
- Clinical efficacy of empiric antibiotic therapy in Chinese patients with cirrhosis and bacterial infections: A multicenter study
- Utility of Blood Neutrophil to Diagnose Bacterial Infections under Satralizumab Treatment for Aquaporin-4 Antibody-positive Neuromyelitis Optica Spectrum Disorder: A Report of Two Cases
- Antibiotic treatment of male urinary tract infections: scientific rationale behind the 2026 SPILF guidelines
- Fabrication and evaluation of a sulfacetamide-loaded niosomal gel for the treatment of ocular bacterial infections
BibTeX
@article{jahangiri2026antibiotic,
title = {{Antibiotic Treatment of Gram-Negative Bacterial Left Ventricular Assist Device Infections: A Systematic Review}},
author = {Parsa Jahangiri and Mehmet Ozgen and Laura Doornekamp and Kadir Caliskan and Nelianne Verkaik},
journal = {Reviews in Cardiovascular Medicine},
year = {2026},
month = oct,
doi = {10.31083/rcm52885},
url = {https://doi.org/10.31083/rcm52885},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Antibiotic Treatment of Gram-Negative Bacterial Left Ventricular Assist Device Infections: A Systematic Review
AU - Parsa Jahangiri
AU - Mehmet Ozgen
AU - Laura Doornekamp
AU - Kadir Caliskan
AU - Nelianne Verkaik
PY - 2026
DA - 2026/10/15
JO - Reviews in Cardiovascular Medicine
DO - 10.31083/rcm52885
UR - https://doi.org/10.31083/rcm52885
AB - Background:: Gram-negative bacterial left ventricular assist device (LVAD) infections pose significant challenges due to antimicrobial resistance and high relapse rates. Moreover, current standardized treatment guidelines remain limited. Thus, this study aimed to evaluate current antimicrobial strategies for Gram-negative bacterial LVAD infections, highlight treatment trends, and examine outcomes to inform clinical decision-making. Methods:: A systematic review was conducted in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they reported antibiotic regimens for Gram-negative LVAD-specific infections and the clinical outcomes of these infections. Antibiotic regimens, associated management strategies, and clinical outcomes were summarized by infection location. Results:: A total of 15 studies were included, reporting 25 cases of Gram-negative LVAD-specific infections and 28 identified Gram-negative pathogens. Most cases involved superficial or deep driveline/exit-site/pocket infections (16/25, 64.0%), whereas pump/cannula infections and device-specific bloodstream infections occurred in 3/25 (12.0%) and 6/25 (24.0%) patients, respectively. Antibiotic strategies varied widely in both selection and duration. Superficial driveline and exit-site infections were treated with a median of 14 days of antibiotics (interquartile range (IQR), 14–21.5; range, 7–49), whereas deep driveline/pocket infections required longer treatment with a median of 42 days (IQR, 31.5–42; range, 14–42). Pump/cannula and bloodstream infections often required prolonged therapy, suppressive treatment, and/or major surgical intervention. Conclusions:: The treatment of Gram-negative bacterial LVAD infections remains highly variable and poorly characterized due to the limited number of reported cases, making it difficult to establish evidence-based clinical recommendations. This highlights the urgent need for further research to establish evidence-based treatment protocols and improve patient outcomes.
SN - 1530-6550
SN - 2153-8174
ER -