PMID- 33417312 OWN - NLM STAT- MEDLINE DCOM- 20210705 LR - 20210705 IS - 1538-943X (Electronic) IS - 1058-2916 (Linking) VI - 67 IP - 5 DP - 2021 May 1 TI - Fluorescence In Situ Hybridization and Polymerase Chain Reaction to Detect Infections in Patients With Left Ventricular Assist Devices. PG - 536-545 LID - 10.1097/MAT.0000000000001260 [doi] AB - The development of driveline infections following left ventricular assist device (LVAD) implantation remains a major problem. We investigated the impact of fluorescence in situ hybridization (FISH) combined with 16S rRNA gene sequencing on the diagnosis of driveline infections. LVAD drivelines (n = 61) from 60 consecutive patients were obtained during LVAD explantation and subjected to FISH analysis. 16S rRNA gene polymerase chain reaction (PCR) and sequencing to identify the microorganisms were performed. Results were compared with those of a standard microbiological culture. The reasons for pump removal were heart transplantation (n = 22), weaning (n = 14), pump exchange due to pump thrombosis (n = 12), technical problems (n = 7), or death (n = 5). Of the 60 patients, 26 exhibited clinical signs of a VAD-specific infection, while 34 (with 35 drivelines) showed no clinical signs of infection before explantation. The spectrum of identified pathogens differed between FISH/PCR and conventional microbiological diagnostics. In general, the bacterial spectrum was more diverse in FISH/PCR as compared with conventional microbiology, which more often showed only typical skin flora (coagulase-negative staphylococci and Corynebacteriaceae). In addition to identifying the species, FISH/PCR provided information about the spatial distribution and invasiveness of the microorganisms. Cultures usually represent the only source of microbiological information for clinicians and often prove to be unsatisfactory in complex LVAD cases. FISH/PCR not only identified a greater number and variety of microorganisms than standard culture did, but it also provided information about the number, localization, and biofilm state of the pathogens, making it a useful tool for diagnosing the specific cause of LVAD driveline infections. CI - Copyright (c) ASAIO 2020. FAU - Schoenrath, Felix AU - Schoenrath F AUID- ORCID: 0000-0002-8221-1295 AD - From the Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany. AD - German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany. FAU - Kursawe, Laura AU - Kursawe L AUID- ORCID: 0000-0002-1532-3334 AD - Biofilmcenter, Institute of Microbiology, Infectious Diseases and Immunology, Charite - University Medical Center Berlin, Freie Universitat Berlin, Humboldt-Universitat zu Berlin, Berlin Institute of Health, Berlin, Germany. FAU - Nersesian, Gaik AU - Nersesian G AD - From the Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany. FAU - Kikhney, Judith AU - Kikhney J AD - Biofilmcenter, Institute of Microbiology, Infectious Diseases and Immunology, Charite - University Medical Center Berlin, Freie Universitat Berlin, Humboldt-Universitat zu Berlin, Berlin Institute of Health, Berlin, Germany. FAU - Schmidt, Julia AU - Schmidt J AD - Biofilmcenter, Institute of Microbiology, Infectious Diseases and Immunology, Charite - University Medical Center Berlin, Freie Universitat Berlin, Humboldt-Universitat zu Berlin, Berlin Institute of Health, Berlin, Germany. FAU - Barthel, Frank AU - Barthel F AD - From the Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany. FAU - Kaufmann, Friedrich AU - Kaufmann F AUID- ORCID: 0000-0001-9617-9225 AD - From the Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany. FAU - Knierim, Jan AU - Knierim J AUID- ORCID: 0000-0002-0514-0016 AD - From the Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany. FAU - Knosalla, Christoph AU - Knosalla C AD - From the Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany. AD - German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany. FAU - Hennig, Felix AU - Hennig F AD - From the Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany. FAU - Falk, Volkmar AU - Falk V AD - From the Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany. AD - German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany. AD - Department of Cardiothoracic Surgery, Charite-University Medical Center Berlin, Freie Universitat Berlin, Humboldt-Universitat zu Berlin, Berlin Institute of Health, Berlin, Germany. FAU - Potapov, Evgenij AU - Potapov E AD - From the Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany. AD - German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany. FAU - Moter, Annette AU - Moter A AD - Biofilmcenter, Institute of Microbiology, Infectious Diseases and Immunology, Charite - University Medical Center Berlin, Freie Universitat Berlin, Humboldt-Universitat zu Berlin, Berlin Institute of Health, Berlin, Germany. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - ASAIO J JT - ASAIO journal (American Society for Artificial Internal Organs : 1992) JID - 9204109 SB - IM MH - Female MH - Heart-Assist Devices/*adverse effects MH - Humans MH - In Situ Hybridization, Fluorescence/*methods MH - Male MH - Middle Aged MH - Polymerase Chain Reaction/*methods MH - Prosthesis-Related Infections/*diagnosis EDAT- 2021/01/09 06:00 MHDA- 2021/07/06 06:00 CRDT- 2021/01/08 13:16 PHST- 2021/01/09 06:00 [pubmed] PHST- 2021/07/06 06:00 [medline] PHST- 2021/01/08 13:16 [entrez] AID - 00002480-202105000-00009 [pii] AID - 10.1097/MAT.0000000000001260 [doi] PST - ppublish SO - ASAIO J. 2021 May 1;67(5):536-545. doi: 10.1097/MAT.0000000000001260.