Cefazolin plus ertapenem and heart transplantation as salvage therapy for refractory LVAD infection due to methicillin-susceptible Staphylococcus aureus: A case series

Jorge L. Cardenas-Alvarez, Jose Suarez, Gabriel Motoa, Shweta Anjan, Yoichiro Natori, Matthias Loebe, Joao R. Breda, Nina Thakkar-Rivera, Anita Phancao, Ali Ghodsizad, Joseph E. Bauerlein, Mrudula R. Munagala, Jacques Simkins

Research output: Contribution to journalArticlepeer-review

Abstract

The use of left ventricular assist devices (LVADs) is increasingly more common as the availability of donor organs in relation to failing hearts is outstandingly limited. Infections are the most common complications in LVAD recipients, particularly those caused by Staphylococcus spp. Refractory LVAD-related infections are not uncommon as achieving adequate source control is often not feasible before heart transplantation. Evidence suggest that cefazolin plus ertapenem is effective in refractory methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia, but this approach has not been described in LVAD recipients. In this article, we report two cases of refractory MSSA bacteremia in LVAD recipients that were successfully treated with salvage therapy with cefazolin plus ertapenem and subsequent heart transplantation. This treatment strategy should be considered in patients with refractory LVAD-associated infection due to MSSA that are not responding to standard treatment.

Original languageEnglish (US)
Pages (from-to)4786-4788
Number of pages3
JournalJournal of cardiac surgery
Volume36
Issue number12
DOIs
StatePublished - Dec 2021

Keywords

  • LVAD infection
  • Staphylococcus aureus
  • bacteremia
  • cefazolin
  • ertapenem
  • salvage therapy

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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