Kyvernitakis A, Pappas O, Farmakiotis D, et al. - Given the common occurrence of bloodstream infection (BSI) following left ventricular assist device (LVAD) implantation that is particularly difficult to treat, researchers here studied LVAD recipients at a single institution. Infections occurred in 58% of 212 patients. Driveline infection (DLI) affected 31%, with 60% of them having deep-tissue involvement. One hundred thirty-five BSIs were reported in 66 patients (31%). They identified systemic inflammatory response syndrome (SIRS) in 47% of BSIs at presentation; it was associated with increased mortality. Independent risk factors for BSI were right heart failure, destination therapy, Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile, morbid obesity, and deep-DLI. An independent association of BSI with mortality was observed. Bridge-to-transplantation (BTT) patients, if they did not have BSIs, more frequently received a transplant. The development of BSI was associated with shorter time-to-transplantation among 104 BTT patients who received heart transplantation. Diagnosis of BSI poses diagnostic and prognostic challenges because of the hemodynamic profile of LVAD patients who may not mount the expected physiologic response to sepsis. Based on these findings, they recommend considering BSIs as a serious complication, similar to pump thrombosis and stroke.