Matters of the heart: A scoping review toward better management of nontuberculous mycobacterial infections of cardiac devices

IF 1.9 Q3 INFECTIOUS DISEASES

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Pub Date : 2025-03-27 DOI:10.1016/j.jctube.2025.100521

Rattanaporn Mahatanan , Maria Alkozah , Devin Lee , Anais A. Ovalle , Natalie B.V. Riblet , Elizabeth A. Talbot

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Abstract

Background

Implantable cardiac device-related (ICDR) nontuberculous mycobacteria (NTM) infections are increasingly reported in the literature, but guidelines for optimal management are lacking.

Methods

We searched Medline, Embase, and Scopus from inception to 1/20/2022 for cases of ICDR NTM infection. Cardiac devices include but are not limited to prosthetic valves, cardiovascular implantable device (CIED), and left ventricular-assist devices (LVAD). We categorized outcomes as death, failure, relapse, cure, and treatment complete.

Main results

A total of 81 articles met our inclusion criteria, representing 122 patients. Eleven different NTM species were reported, with rapidly growing mycobacteria (RGM) including M. fortuitum, M. chelonae, and M. abscessus comprising approximately 60 % of the identified organisms. Prosthetic heart valves (N = 61; 50 %) and CIED (N = 46; 38 %) were the most frequently associated cardiac devices. Favorable outcomes, defined as treatment complete and cure, were significantly associated with device removal after adjusting for age, gender, and device type (aOR 3.45, 95 %CI 1.30–9.14).

Conclusion

We found that patients who underwent device removal had better outcomes than those with retained devices. Device removal should be strongly considered when possible.

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心脏问题：对心脏装置非结核性分枝杆菌感染的更好管理的范围审查

背景植入式心脏装置相关（ICDR）非结核分枝杆菌（NTM）感染在文献中越来越多地报道，但缺乏最佳管理指南。方法检索Medline、Embase和Scopus自成立以来至2022年1月20日的ICDR NTM感染病例。心脏装置包括但不限于人工瓣膜、心血管植入式装置（CIED）和左心室辅助装置（LVAD）。我们将结果分类为死亡、失败、复发、治愈和治疗完成。主要结果共有81篇文章符合我们的纳入标准，代表122例患者。报告了11种不同的NTM物种，其中快速生长的分枝杆菌（RGM）包括M. fortuitum， M. chelonae和M.脓肿，约占鉴定生物的60%。人工心脏瓣膜(N = 61；50%)和CIED (N = 46；38%)是最常见的相关心脏装置。在调整了年龄、性别和装置类型后，良好的结果（定义为治疗完成和治愈）与装置移除显著相关（aOR 3.45, 95% CI 1.30-9.14）。结论：我们发现取出装置的患者比保留装置的患者预后更好。在可能的情况下，应该强烈考虑移除设备。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Medicine-Pulmonary and Respiratory Medicine

CiteScore

4.00

自引率

5.00%

发文量

审稿时长

30 weeks

期刊介绍： Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.