Table 1 Clinical features, causative organisms, management and outcomes
Patient No. | Age | Co-mobidity Index | Index device and indication | Early complications/ Index device infection features | Other surgical history prior to Time Zero (first entry to OPAT) | First clinical presentation with infection | Leucocytosis at presentation | Organism(s) cultured | Managment of index device infection | No. of OPAT episodes | Outcome of most recent OPAT episode (months post presentation with infection, cause of death) |
|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 84 | 7 | Emergency EVAR for AAA Rupture | Bacteraemic at time of EVAR insertion, suspected AEF | Fever | No | Bacteroides fragilis (blood culture) | OPAT, lifelong oral suppresion | 1 | Failure – RIP (10- pancreatic carcinoma) | |
2 | 80 | 4 | Elective EVAR for AAA size | Suspected AEF | Fever, abdominal pain | No | Salmonella enteritidis, Streptococcus anginosis (blood culture, sac aspirate) | Sac aspirate, OPAT, lifelong oral suppression | 3 | Partial success, 45 | |
3 | 79 | 5 | Emergency EVAR for AAA Rupture + fem-fem bypass graft | nNo | Fever, back pain, anorexia, melena | No | None | OPAT, lifelong oral suppression | 2 | Partial success, 34 | |
4 | 69 | 5 | Semi-elective EVAR for AAA size + fem-fem bypass graft | Endoleak, LRTI post-op | Repair of endoleak 3 days after initial surgery | Abdominal pain, anorexia | No | None | OPAT, lifelong oral suppression | 2 | Partial success, 47 |
5 | 71 | 7 | Elective EVAR for AAA size | Endoleak | Repositioning of stent | Anorexia, abdominal pain, back pain | CoNS, (sac aspirate) | Sac aspirate, OPAT, lifelong oral suppression | 1 | Failure – RIP (27- severe cardiac failure and cardiogenic shock) | |
6 | 81 | U | Semi-elective EVAR for AAA size, mycotic aneurysm | Suspected AEF | Back pain | No | None | OPAT, lifelong oral suppression | 1 | Success, 25 | |
7 | 68 | 4 | Elective EVAR for AAA size | Fever for 3 days post deployment, no focus found, radiology no collection | Fever | Yes | None | OPAT, oral consolidation 6 months | 1 | Success, 36 | |
8 | 75 | 4 | EVAR for AAA size and symptoms | Occlusion of right limb of EVAR, suspected AEF | Fever, abdominal/back pain, anorexia, bleeding | Yes | Enterococcus faecalis, Bacteroides caccae (vertebral biopsy) | OPAT, lifelong oral suppression | 3 | Partial success, 40 | |
9 | 70 | 4 | Semi-elective EVAR for AAA size and symptoms | Right hip pain | Ax-fem bypass graft right limb balloon angioplasty sac drainage | Anorexia, collection formation | Yes | Pseudomonas (sac aspirate, blood culture) | Multiple debridements and drainage, explant + allograft OPAT, lifelong oral suppression | 3 | Partial success, 25 |
10 | 81 | 7 | Elective EVAR for symptoms | Wound infection post-op | Fem-fem bypass graft with development of sinus | Fever, back pain, anorexia, cachexia | No | MSSA, Pseudomonas aeruginosa, anaerobes, CoNS, Enterococcal sp. (VRE) – (sinus swabs/excision) | Sinus excision, OPAT, lifelong oral suppression | 2 | Partial success, 60 |
11 | 86 | 10 | Elective EVAR for AAA size | No | Fem-fem cross over for limb occlusion with development of sinus of fem-fem graft | Fever | Yes | Staphylococcus caprae, candida (excised sinus) | Sinus excision, OPAT, lifelong oral suppression | 1 | Failure – RIP (5 – multilobar pneumonia) |