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NHLBI Working Group
Antimicrobial Strategies and Cardiothoracic Surgery
Executive Summary
The National Heart, Lung, and Blood Institute (NHLBI) and the National
Institute of Allergy and Infectious Diseases (NIAID) convened a Working
Group of investigators on April 4-5, 2002, in Bethesda, Maryland.
This Working Group brought together experts to explore both basic
science and clinical application research opportunities of antimicrobial
strategies in the prevention and treatment of major infections following
cardiac surgery.
The following recommendations were made to NHLBI and NIAID:
- Utilize and expand databases such as the VAH, STS, Duke, and
CCF to prospectively study the incidence and type of infection
in a large group of patients undergoing heart surgery.
- Support basic science research projects into virulence mechanisms
and infectivity of S. aureus and other pathogens in cardiovascular
surgical situations and device use.
- Foster liaisons with industry and provide incentives for novel
product development and clinical evaluation in cardiovascular
clinical trials.
- Collaborate with other Agencies to support multi-center, multidisciplinary
medical/surgical staff teams of hospital-based “Cardiac
Surgical Intervention Teams” to address optimal strategies
for reducing the risk of cardiac surgical-related infections.
Topics include control of nasal staphylococcal colonization,
optimizing preoperative surgical preparatory interventions,
and rigorous approaches to antibiotic or antibody prophylaxis
strategies before and during surgery.
- Conduct randomized clinical trials to evaluate prevention
vs. therapy of S. aureus infections in patients undergoing
cardiovascular procedures. In particular, design a clinical
trial to study the efficacy of S. aureus conjugate vaccine
in patients scheduled for cardiac surgery. These trials have
different issues with regard to design and implementation,
and decisions about which approaches will be most fruitful
will require extensive deliberation and planning.
Working Group Members
- Franklin D. Lowy, M.D., Columbia University, New York, NY (Co-chair)
- John A. Waldhausen, M.D., the Pennsylvania State University
College of Medicine Hershey, PA (Co-chair)
- Arnold Bayer, M.D., Harbor UCLA Medical Institute, Torrence,
CA
- Robert Califf, M.D., Duke University Medical Center, Durham,
NC
- George Eliopoulos, M.D., Beth Israel Deaconess Medical Center,
Boston, MA
- Ali Fattom, Ph.D., NABI, Rockville, MD
- Vance Fowler, M.D., Duke University Medical School; Durham,
NC
- Marc Gillinov, M.D., the Cleveland Clinic Foundation, Cleveland,
OH
- Frederick Grover, M.D., University of Colorado, Denver, CO
- Magnus Hook, Ph.D., Matrix Biology, Houston, TX
- J. Glen Morris, M.D., MPH, TM, University of Maryland, Baltimore,
MD
- Joseph Patti, Ph.D., Inhibitex, Alpharetta, GA
- Timothy Pruett, M.D., University of Virginia, Charlottesville,
VA
- John Robbins, M.D., National Institute of Child Health and
Development, Bethesda, MD
- Martin Rosenberg, Ph.D., Promega Corporation, Madison, WI
- Rachel Schneerson, M.D., National Institute of Child Health
and Development Bethesda, MD
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