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Oxacillin plus ertapenem rapidly clears persistent left ventricular assist device-related methicillin-susceptible Staphylococcus aureus bacteremia
  • H Andrew Wilsey,
  • Barbara Pisani,
  • Thomas O’Neill J
H Andrew Wilsey
Wake Forest Baptist Medical Center

Corresponding Author:[email protected]

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Barbara Pisani
Wake Forest Baptist Medical Center
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Thomas O’Neill J
Wake Forest Baptist Medical Center
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There is an increasing use of left ventricular assist devices (LVADs) as bridge to transplantation or permanent destination therapy in the heart failure patient population. Infection remains a common complication in LVADs, with Gram-positive skin flora as predominant pathogens implicated, including Staphylococcus aureus. While there is emerging evidence for synergistic antibiotic combinations with methicillin resistant Staphylococcus aureus, there remains a significant gap in the literature for persistent methicillin susceptible Staphylococcus aureus (MSSA) bacteremia. In this article, we describe the first successful treatment of persistent LVAD-related bacteremia with salvage oxacillin plus ertapenem. The salvage therapy described here must be balanced by the risks for toxicity, impact on resistance, microbiota disruption, drug shortages, and patient costs. This combination warrants further evaluation in the clinical setting to better establish its role in our expanding patient population.
24 Feb 2022Submitted to Journal of Cardiac Surgery
24 Feb 2022Submission Checks Completed
24 Feb 2022Assigned to Editor
24 Feb 2022Reviewer(s) Assigned
11 Mar 2022Review(s) Completed, Editorial Evaluation Pending
11 Mar 2022Editorial Decision: Revise Major
15 Mar 20221st Revision Received
16 Mar 2022Submission Checks Completed
16 Mar 2022Assigned to Editor
16 Mar 2022Reviewer(s) Assigned
28 Mar 2022Review(s) Completed, Editorial Evaluation Pending
28 Mar 2022Editorial Decision: Accept
07 Apr 2022Published in Journal of Cardiac Surgery. 10.1111/jocs.16491