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Rad Hrvatske akademije znanosti i umjetnosti. Medicinske znanosti, No.509=36 Ožujak 2011.
Pregledni rad
Antimicrobial Prophylaxis and Infection Control in Cases of Mechanical Cardiac Support Devices
Jasenka Škrlin
; Department for Clinical Microbiology and Hospital Infections, University Hospital Dubrava, Zagreb, Croatia
Željko Sutlić
; Department for Cardiac Surgery, Surgery Clinic of the Medical School in Zagreb, University Hospital Dubrava, Zagreb, Croatia
Davor Barić
; Department for Cardiac Surgery, Surgery Clinic of the Medical School in Zagreb, University Hospital Dubrava, Zagreb, Croatia
Igor Rudež
; Department for Cardiac Surgery, Surgery Clinic of the Medical School in Zagreb, University Hospital Dubrava, Zagreb, Croatia
Danijel Unić
; Department for Cardiac Surgery, Surgery Clinic of the Medical School in Zagreb, University Hospital Dubrava, Zagreb, Croatia
Puni tekst: pdf (476 KB),
Engleski,
Str. 109 - 122
,
Sažetak
Ventricular assist devices (VADs) for patients with severe heart failure are improving, and there are increasing numbers of implants, as device therapy enters the era of permanent use (i.e. destination therapy). The device-related infection of implanted pumps and sepsis remain important risk factors for death, and once infections are established on biomaterial surfaces, they usually persist despite prolonged antimicrobial therapy. Biofilm forming is the crucial moment in the pathogenesis of many subacute and chronic bacterial infections, including the infections connected with a foreign body. Biofilm is a significant clinical problem. Its eradication by conventional antimicrobial agents is rather complicated, as it disposes of several mechanisms for developing resistance to antibiotics. The role of persisting cells is crucial in the context of the tolerance of bacterial biofilm towards antimicrobials. The mechanism for biofilm forming and the consequential antimicrobial resistances are the key to developing new therapeutic strategies. Therefore, adherence to evidence-based infection control and prevention guidelines, meticulous surgical technique and optimal post-operative surgical site care form the foundation for VAD-associated infection prevention.
Ključne riječi
ventricular assist device; infection; biofilm; antimicrobial therapy; prevention guidelines
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