Heart Devices, Infections and Treatments
Rochester, MN - When M. Rizwan Sohail, M.D., entered his fellowship in infectious disease at Mayo Clinic in Rochester, Minn., nearly a decade ago, an important trend was under way. The number of patients with newly implanted pacemakers, replacement valves and other heart devices was on the rise, and the technology was saving lives. But, he quickly learned, there was also a down side.
"We were seeing many cases of device infections," Dr. Sohail recalls. And because the devices were so new, no protocols existed to treat the infections.
But the infections were oddly familiar. They followed a pattern similar to that of an uncommon disease that had been a medical mystery for more than a century — endocarditis, an infection of the inner lining of the heart (endocardium) that can damage or destroy heart valves.
The patients Dr. Sohail studied tested positive for bacteria that existed in clusters on the heart valves. The bacteria were encased in high concentrations within a protective layer called biofilm. They had low metabolic activity and grew slowly. Because most antibiotics work best when bacteria are rapidly reproducing, this cardiac infection was hard to treat.
A legacy of expertise and discovery
Concern about his patients with lifesaving implants piqued Dr. Sohail's research curiosity. He steered his work to study device infections, to find out how common they are, and to determine how best to treat them. He happened to be in the right place. For more than 60 years, researchers at Mayo Clinic have maintained special interest in endocarditis, and their work has had an impact on treatment worldwide. Continue>
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