Impact of Showering Methods on Driveline Exit Site Microbiology and Driveline Infection in Patients With Left Ventricular Assist Devices

Driveline infection (DLI) remains a major complication in patients with a left ventricular assist device (LVAD). This study evaluated the impact of different showering methods on bacterial colonization at the driveline exit site (DLES) and the incidence of DLI. Patients who underwent LVAD implantation at our institute from 2008 to 2021 were included and classified into two groups: the open group, in which the DLES was exposed and washed with running water, and the covered group, in which the DLES was sealed with a waterproof dressing during showering. The primary outcome was the incidence of DLI within 3 years following hospital discharge. A total of 103 patients were included (the open group, n = 47; the covered group, n = 56). The DLI-free rate was significantly higher in the covered group than the open group (77% vs. 49%; p = 0.003). Pseudomonas aeruginosa was detected less frequently at the DLES, and DLI caused by P. aeruginosa was significantly reduced in the covered group. Multivariate analysis suggested that the open showering method was an independent risk factor for DLI (hazard ratio, 2.816; 95% confidence interval, 1.325-5.984; p = 0.007). The covered showering method was associated with a significantly lower incidence of DLI, particularly infections caused by P. aeruginosa.