engleski

Microbiology of cardiac implantable electronic device infections

Cardiac implantable electronic device (CIED) infection is rare but potentially dangerous complication. Literature data showes mortality of 30-35% in CIED infections and 20-25% in valve endocarditis. The aim of study was describe a tertiary care center experience with the microbiology of CIED infections. We described clinical characteristics, type of microorganism, complications and outcome of CIED infections in ten patients. In our hospital between January 2006 and November 2017 CIED infection was identified in ten patients, 6 male and 4 female, age 24-80 years, mean age 62.1 years. Criteria for CIED infections are related to clinical findings, positive blood cultures with causative microorganism or echocardiographic evidence of vegetation associated with transvenous leads or right-sided heart valves. Clinical features of patients are: fever in 10, heart failure in 2, pulmonary embolism in 1, and chills in 3 patients. Echocardiography demonstrated lead vegetation in 8 patients, 2 patients had concomitant TV vegetations. Mean interval between device implantation and first findings of infection was 3.3 years. Blood culture was positive in 9 (90%) patients. Isolated causative organisms in blood culture and extracted leads are: staphylococci in 4 (40%), of which 2 were MRSA, streptococci in 2 (29%), Pseudomonas aeruginosa 1 (10%), Corinebacterium spewc. 1(10%), and Enterococcus in 1 (10%). Treatment with a combination of antibiotics and surgical lead extraction was performed in 7 patients whil treatment with placement of new epicardial leads and LVAD explantation was performed in 2 patients. Concomitant valve surgery was performed in 2 patients. Staphylococcus aureus and S. epidermidis were the most common causative organisms in CIED infections.

Microbiology ; Cardiac implantable electronic device ; Infection

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