Guthoff, Henning 
ORCID: 0000-0002-0979-1190, Lohner, Valerie ORCID: 0000-0001-5589-9701, Mons, Ute ORCID: 0000-0003-1764-6783, Götz, Julia ORCID: 0009-0003-5003-7821, Wienemann, Hendrik ORCID: 0000-0001-5810-2868, Wrobel, Jan ORCID: 0000-0002-1637-3413, Nienaber, Stephan ORCID: 0000-0001-5779-7549, Macherey-Meyer, Sascha ORCID: 0000-0002-7080-6611, von Stein, Philipp ORCID: 0000-0003-4548-3897, Baldus, Stephan ORCID: 0000-0001-8259-1737, Adam, Matti ORCID: 0000-0002-6990-8135, Körber, Maria Isabel ORCID: 0000-0001-9073-9279, Jung, Norma ORCID: 0000-0002-5740-0772 and Mauri, Victor ORCID: 0000-0003-2678-3501
(2025).
Evaluation of systemic inflammatory response following transcatheter aortic valve replacement: a pathway to rational antibiotic use.
Infection, 53 (5).
pp. 1725-1735.
Springer Nature.
ISSN 0300-8126
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Abstract
Purpose: Elevations in inflammatory markers after transcatheter aortic valve replacement (TAVR) often lead to preemptive antibiotic therapy (ABT). Distinguishing between physiological inflammatory reaction and true infection is crucial for rational ABT use. Methods: This retrospective study included 1275 consecutive TAVR patients from January 2020 to July 2022. Infectious foci, ABT administration, and inflammatory markers over seven days post-procedure were evaluated. Using multivariable logistic regression, predictors for infection were identified and integrated into the Risk of Infection After TAVR (RIAT) score. Results: An infectious focus was retrospectively identified in 2.6% of patients, while 11.4% received ABT. Distinct trends in body temperature (BT), white blood cells (WBC), and C-reactive protein (CRP) were noted, with BT and WBC peaking on day 1 and CRP on day 3. Significant predictors of infection included a rise in BT of ≥ 0.2 °C between day 1 and 3 (odds ratio [OR] 3.08, 95% confidence interval [CI] 1.38–6.88, p = 0.006), elevated WBC counts ≥ 12 × 10 9 /L (OR 3.77, 95% CI 1.67–8.48, p = 0.001), and CRP levels ≥ 80 mg/L (OR 5.72, 95% CI 2.59–12.64, p < 0.001) within three days after TAVR. Integrating these into the RIAT score revealed an infection probability of 1.5% for scores 0–3 points, 9.2% for scores 4–6 points, and 54.5% for scores 7–8 points. Conclusion: Our findings indicate significant ABT overuse among TAVR recipients, likely due to misinterpretation of postoperative physiological reactions. Incorporating specific changes and thresholds of BT, WBC, and CRP post-TAVR into the RIAT score improved risk prediction for infection, underscoring its utility in enhancing antibiotic stewardship in this growing patient population.
| Item Type: | Article |
| Creators: | Creators Email ORCID ORCID Put Code |
| URN: | urn:nbn:de:hbz:38-797775 |
| Identification Number: | 10.1007/s15010-025-02485-0 |
| Journal or Publication Title: | Infection |
| Volume: | 53 |
| Number: | 5 |
| Page Range: | pp. 1725-1735 |
| Number of Pages: | 11 |
| Date: | 7 October 2025 |
| Publisher: | Springer Nature |
| ISSN: | 0300-8126 |
| Language: | English |
| Faculty: | Faculty of Medicine |
| Divisions: | Faculty of Medicine > Innere Medizin > Klinik I für Innere Medizin - Hämatologie und Onkologie Faculty of Medicine > Innere Medizin > Klinik III für Innere Medizin - Kardiologie, Pneumologie, Angiologie und internistische Intensivmedizin |
| Subjects: | Medical sciences Medicine |
| ['eprint_fieldname_oa_funders' not defined]: | Publikationsfonds UzK |
| Refereed: | Yes |
| URI: | http://kups.ub.uni-koeln.de/id/eprint/79777 |
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