Abstract
Invasive cardiovascular procedures which include heart transplantations, congenital heart surgery, coronary artery bypass grafts, cardiac valve repair and replacement, and interventional cardiac electrophysiology procedures represent common mechanisms to treat a variety of cardiovascular diseases across the globe. The majority of these invasive approaches employ antibiotics as a regular and obligatory feature of the invasive procedure. Although the growing incidence of bacterial resistance to currently used antibiotics threatens to curtail the use of all interventional surgical techniques, it remains an underappreciated threat within the arsenal of cardiovascular therapies. It is reasonable to expect that the continued overuse of antibiotics and the frequent management of coronavirus disease 2019 (COVID-19) infected patients with high doses of antibiotics will inevitably accentuate the rise of multidrug resistance. The purpose of this article is to heighten awareness of the role of bacterial infections in cardiovascular disease, the use of antibiotics in today's cardiovascular surgical theaters, the threat facing cardiovascular surgery should multidrug resistance continue to rise unabated, and the development of new antibiotic platforms to solve this problem.
Highlights
Life style, diet and behavioural changes play an increasingly important therapeutic and preventative role in cardiovascular disease (CVD) [1], cardiac surgery remains a valuable and integral clinical tool to address heart and vascular disease
A recent systematic review of 12 studies documented the presence of Yersinia sp. in infective endocarditis, most commonly in the mitral valve and in the aortic valve [10]
Actinetobacter baumannii and Actinetobacter calcoaceticus complexes are becoming a serious problem in intensive care units, as these species become increasingly resistant to conventional antibiotic therapy
Summary
The primary forms of cardiovascular invasive procedures used today are heart transplantation, congenital heart disease, coronary artery bypass grafts (CABG), percutaneous coronary artery interventions (PCI), cardiac valve repair and replacement, and interventional cardiac electrophysiology procedures The types of bacterial species found to infect patients during cardiovascular surgery are varied. Oral flora like Rothia aeria and Rothia dentocariosa have been recovered from patients during cardiac surgery and have been suggested to be rare but significant causes of infective endocarditis [17]
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