Evaluation of Driveline Infections in Diabetic Patients with Left Ventricular Assist Devices

Objectives: Left ventricular assist devices (LVADs) are critical in advanced heart failure management, yet driveline infections remain a significant complication. This study aimed to evaluate the microbiological profile and clinical outcomes of driveline infections in diabetic and nondiabetic LVAD patients.
Methods: We conducted a retrospective analysis of 40 LVAD patients with driveline infections between January 2020 and December 2024. Microorganisms were categorized as gram-positive, gram-negative, or fungal agents, and their prevalence was compared between diabetic and nondiabetic groups. Clinical outcomes, including recurrence, bacteremia, and mortality, were analyzed.
Results: Gram-positive bacteria were the most commonly isolated microorganisms in both diabetic (53.2%) and nondiabetic (63.6%) groups, with no statistically significant difference (p=0.285). Staphylococcus aureus was more frequently isolated in nondiabetic patients (25% vs. 12.9%, p=0.110). Gram-negative bacteria and fungal agents were identified in 35.8% and 6.6% of cases, respectively, with similar distributions across groups. Mortality was primarily influenced by age (AOR: 0.879, 95% CI: 0.789-0.979, p=0.019), while other demographic and clinical factors showed no significant associations.
Conclusion: The microbiological profile of driveline infections in diabetic and nondiabetic LVAD patients is comparable, with minor differences in pathogen prevalence. Age was a significant independent risk factor for mortality, whereas diabetes did not contribute to differences in clinical outcomes. Larger, prospective studies are needed to validate these findings and optimize infection management strategies.