Bloodstream infections in patients with transcatheter aortic valve replacement

•Surprisingly, there are limited published data regarding bloodstream infections (BSI) in patients undergoing transcatheter aortic valve replacement (TAVR).•This is the first population-based investigation of its kind on BSI and IE following TAVR.•The incidence of BSI was alarming (1300 episodes/100,000 persons per annum), with VGS being the most common pathogen.•Forty percent of patients with BSI developed IE.•Additional investigation of risk factors associated with BSI is mandated so that modification of them could potentially reduce BSI incidence. To evaluate incidence and risk factors of bloodstream infections (BSI) in patients with transcatheter aortic valve replacement (TAVR). We conducted a population-based study in southeastern Minnesota using the expanded Rochester Epidemiology Project (e-REP) for all adult (≥18 years) patients who underwent TAVR from January 1, 2010 to December 31, 2018. The incidence of BSI following TAVR was 1300 episodes/100,000 persons per annum. The median time to BSI following TAVR was 610 days and 84% were community-acquired. Forty percent of BSI cases developed infective endocarditis. Viridans group streptococci (VGS) were the most common pathogens and 80% of patients with VGS BSI had IE. The high incidence of BSI among TAVR patients is alarming and is likely due to advanced age and comorbid conditions. Because 40% of BSI patients also developed IE, further investigation of modifiable risk factors associated with BSI is warranted.