Infection Control and Prevention Practices for Mechanical Circulatory Support: An International Survey

Purpose Infection is common complication associated with significant morbidity and mortality after implantation of mechanical circulatory support (MCS) devices. Standardized infection prevention practices have not been established. Methods and Materials An international survey to investigate the current infection prevention (IP) practices with MCS was conducted through an electronic survey. Through an ISHLT mailing, 210 centers identified a representative to complete the survey managed by the Research Survey Center at Mayo Clinic. Data regarding pre, peri, and post-implantation practices was collected. Results Representatives from 56 centers have completed the survey by November 2012. 37 (66.1%) centers routinely evaluate for pre-implant bacterial colonization; 35 for MRSA by nasal swab, 14 for MSSA and 7 for resistant gram-negatives. Pre-implant IP included antiseptics (94.6%) and pre-op chlorhexidine bath (62.6%). Pre-implant antibiotics given within 1 hour (60%) included vancomycin (82.1%), rifampin (32.1%), ciprofloxacin (21.4%) and antifungal (47.3%). The majority report antimicrobials duration for 24-48h (56%). Operative techniques reported included placing velour driveline portion subcutaneously (78.2%) and contralateral placement of driveline exit from device (61.5%). In addition, most centers reported willingness to participate in future IP trials. Conclusions Common IP practices were reported in the majority of MCS centers though subtle differences exist. Future consensus building and design of multi-center intervention studies in MCS may be developed based on this survey.