{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T22:45:52Z","timestamp":1763160352078,"version":"3.45.0"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We report a 62-year-old male who had a Heartware left ventricular assist device (LVAD) implantation and subsequently developed a persistent driveline infection, culminating in an abscess along the driveline site despite 18\u00a0months of antibiotic treatment. His situation was further complicated post-transplant by the onset of mediastinitis, linked to a previously undervalued Stenotrophomonas maltophilia infection. This report highlights the potential risks of heart transplantation in patients with unresolved LVAD driveline infections, particularly mediastinitis. The presence of existing driveline infections, combined with the immunosuppressed status of patients, necessitates aggressive surgical measures. Our treatment approach, involving multiple mediastinal washouts, omental flap use, antibiotic bead placement, and an extended post-discharge antibiotic regimen, led to a successful patient outcome. The case emphasizes the importance of thorough antimicrobial coverage for all identified pathogens post-transplantation and advocates for aggressive surgical intervention in managing postoperative complications associated with LVAD driveline infections.<\/jats:p>","DOI":"10.1093\/jscr\/rjaf892","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T22:43:18Z","timestamp":1763160198000},"source":"Crossref","is-referenced-by-count":0,"title":["Management of\n                    <i>Stenotrophomonas mediastinitis<\/i>\n                    after heart transplantation for persistent driveline infection: a case report"],"prefix":"10.1093","volume":"2025","author":[{"given":"James Lee","family":"West","sequence":"first","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Surgery, University of Alabama at Birmingham , 19th Street South, Birmingham, AL 35294 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles W","family":"Hoopes","sequence":"additional","affiliation":[{"name":"Department of Surgery, Thomas Jefferson University Hospital , 111 South 11th Street, Philadelphia, PA 1907 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2920-4659","authenticated-orcid":false,"given":"Jeremey","family":"Walker","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Surgery, University of Alabama at Birmingham , 19th Street South, Birmingham, AL 35294 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anoma","family":"Nellore","sequence":"additional","affiliation":[{"name":"Infectious Diseases, NYU Langone Hospitals , 550 First Avenue, New York, NY 10016 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik J","family":"Orozco-Hernandez","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Surgery, University of Alabama at Birmingham , 19th Street South, Birmingham, AL 35294 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"key":"2025111417431024400_ref1","doi-asserted-by":"publisher","first-page":"1565","DOI":"10.1016\/S0003-4975(02)04905-6","article-title":"Mediastinitis in heart and lung transplantation: 15 years experience","volume":"75","author":"Abid","year":"2003","journal-title":"Ann Thorac Surg"},{"key":"2025111417431024400_ref2","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1016\/S1053-2498(03)00104-9","article-title":"Bacterial mediastinitis after heart transplantation: clinical presentation, risk factors and treatment","volume":"23","author":"Senechal","year":"2004","journal-title":"J Heart Lung Transplant"},{"key":"2025111417431024400_ref3","doi-asserted-by":"publisher","first-page":"1084","DOI":"10.1016\/j.healun.2007.07.036","article-title":"Incidence, treatment strategies and outcome of deep sternal wound infection after orthotopic heart transplantation","volume":"26","author":"Filsoufi","year":"2007","journal-title":"J Heart Lung Transplant"},{"key":"2025111417431024400_ref4","doi-asserted-by":"publisher","first-page":"O197","DOI":"10.1111\/1469-0691.12369","article-title":"Mediastinitis due to gram-negative bacteria is associated with increased mortality","volume":"20","author":"Charbonneau","year":"2014","journal-title":"Clin Microbiol Infect"},{"key":"2025111417431024400_ref5","doi-asserted-by":"publisher","first-page":"S388","DOI":"10.1093\/cid\/ciu594","article-title":"Carbapenem-resistance in gram-negative bacilli and intravenous minocycline: an antimicrobial stewardship approach at the Detroit Medical Center","volume":"59","author":"Pogue","year":"2014","journal-title":"Clin Infect Dis"},{"key":"2025111417431024400_ref6","article-title":"Evaluation of the performance of manual antimicrobial susceptibility testing methods and disk breakpoints for Stenotrophomonas maltophilia","volume":"95","author":"Khan","year":"2023","journal-title":"Antimicrob Agents Chemother"},{"key":"2025111417431024400_ref7","doi-asserted-by":"publisher","first-page":"ofaa008","DOI":"10.1093\/ofid\/ofaa008","article-title":"Stenotrophomonas bacteremia antibiotic susceptibility and prognostic determinants: mayo clinic 10-year experience","volume":"7","author":"Hamdi","year":"2020","journal-title":"Open forum Infect Dis"},{"key":"2025111417431024400_ref8","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1016\/j.healun.2017.06.007","article-title":"An ISHLT consensus document for prevention and management strategies for mechanical circulatory support infection","volume":"36","author":"Kusne","year":"2017","journal-title":"J Heart Lung Transplant"}],"container-title":["Journal of Surgical Case 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