Pseudomonas aeruginosa Infection Predicts Need for Surgical Incision and Drainage in LVAD Patients with Driveline Infection

Purpose Driveline infection (DLI) is a frequent cause of morbidity and mortality in LVAD pts. Infections caused by Pseudomonas (P) aeruginosa, an organism that is widespread in water, are difficult to treat due to limited antibiotic susceptibility and tendency to form biofilms. Surgical incision and drainage (ID and ii) recurrent ID 81% M; 63% HMII, 27% HM3, 10% other) were studied. DLI occurred in 87 (15%) pts. Baseline characteristics were similar in pts with and without DLI. 116 organisms were cultured from the 87 pts. The most common were Staphylococcus aureus (MSSA 27%, MRSA 9%) and P. aeruginosa (19%). Median [IQR] time to initiation of antibiotics was 0[3]d. Initial antibiotic strategy was oral in 51 (58.6%) pts and intravenous in 36 (41.4%) pts. 59 (68%) pts were placed on chronic suppressive antibiotics. 31 (36%) pts required ID Table 1a). A positive association was also found between P. aeruginosa and bacteremia with need for recurrent I&D or death (Table 1b). Conclusion Need for I&D is associated with poor survival. P. aeruginosa independently predicts need for initial I&D. Reinforcement of strict no showering/bathing policy may help decrease the risk of P. aeruginosa DLI and improve outcomes in this population.