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Bacterial Infection of Pacemaker in Patients with Endocarditis

Fariba Fayaz, Sara Rahmati roodsari, Latif Gachkar, Bita Pourkaveh
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Abstract

Background: The advancement of technology in recent decades has been lead to use the electrophysiology cardiac devices. Although these devices are used increasingly, but the frequency of subclinical infection is unknown. We investigate bacterial infections due to implantable cardioverter defibrillator (ICDs) in patients with endocarditis.

Materials and Methods: Population of the study was considered among all adult patients in whom the cardiac electrophysiology device was removed. Associated infection endocarditis defined by the Duke criteria. 35 pacemakers (PM) were aseptically removed from these patients during January 2012 to November 2014. Intraoperative swabs from the different part of devices were collected, cultured in BHI (Brain Heart Infusion Broth) and then bacterial classical cultures were done under aerobic and anaerobic conditions. Biochemical and differential media were used to detect the bacteria species. Data analysis was performed by using SPSS version 16 software.

Results: 13 cases of 35 patients with endocarditis diagnosed by modified Duke Criteria and removed pacemaker had positive culture. Of the 13 cases with infection 43% were identified as gram positive and 57% had gram negative bacteria.

Conclusion: Based on our study and similar studies, bacteria can colonize in electrophysiology devices which can lead to bacterial infections.

 


Keywords

Key words: Pacemaker,Bacterial infection,Endocarditis

References

Prieto D, Correia P, Batista M, Sola E, Franco F, Costa S, et al. A decade of cardiac transplantation in Coimbra: The value of experience. Rev Port Cardiol. 2014 Nov;33(11):671-681.

Chambers ST. Diagnosis and management of staphylococcal infections of pacemakers and cardiac defibrillators. Intern Med J. 2005;35:S63–71.

Sandoe JA, Barlow G, Chambers JB, Gammage M, Guleri A, Howard P, et al. Guidelines for the diagnosis, prevention and management of implantable cardiac electronic device infection. Report of a joint Working Party project on behalf of the British Society for Antimicrobial Chemotherapy (BSAC, host organization), British Heart Rhythm Society (BHRS), British Cardiovascular Society (BCS), British Heart Valve Society (BHVS) and British Society for Echocardiography (BSE). J Antimicrob Chemother. 2014 Oct 29.

Hemmer W, Frohlig G, Markewitz A. Comment on NASPE recommendations for removal of permanently implanted, transvenous cardiac pacemaker and defibrillator electrodes. Z Kardiol. 2002;91:956–68.

Kim DH, Tate J, Dresen WF, Papa FC Jr, Bloch KC, Kalams SA, Ellis CR, Baker MT, Lenihan DJ, Mendes LA, Cardiac implanted electronic device-related infective endocarditis: clinical features, management, and outcomes of 80 consecutive patients, Pacing Clin Electrophysiol. 2014;37(8):978-85.

Al Abri SS, Zahedi FI, Kurup PJ, Al-Jardani AK, Beeching NJ. The epidemiology and outcomes of infective endocarditis in a tertiary care hospital in Oman. J Infect Public Health. 2014;7(5):400-6.

Borer A, Gilad J, Hyam E, Schlaeffer F, Schlaeffer P, Eskira S, et al. Prevention of infections associated with permanent cardiac antiarrhythmic devices by implementation of a comprehensive infection control program. Infect Control Hosp Epidemiol. 2004;25:492–7.

Catanchin A, Murdock CJ, Athan E. Pacemaker infections: a 10-year experience. Heart Lung Circ. 2007.

Sohail MR, Uslan DZ, Khan AH, Friedman PA, Hayes DL, Wilson WR et al. Risk factor analysis of permanent pacemaker infection. Clin Infect Dis. 2007;45:166–73.

Uslan DZ, Sohail MR, St Sauver JL, Friedman PA, Hayes DL, Stoner SM, et al. Permanent pacemaker and implantable cardioverter defibrillator infection: a population-based study. Arch Intern Med. 2007;167:669–75.

Duval X, Selton-Suty C, Alla F, Salvador-Mazeq M, Bernard Y, Weber M, et al. Endocarditis in patients with a permanent pacemaker:a1year epidemiological survey on infection endocarditis due to valvular and or pacemaker infection. Clinical Infec. Dis. 2004;39:68-74

Zhan C, Baine WB, Sedrakyan A, Steiner C. Cardiac device implantation in the United States from 1997 through 2004: a population-based analysis. J Gen Intern Med. 2007;23(suppl 1):13–9.

Uslan DZ, Tleyjeh IM, Baddour LM, Friedman PA, Jenkins SM, St Sauver JL, et al. Temporal trends in permanent pacemaker implantation:a population-based study. Am Heart J. 2008;155:896 –903.

Lin G, Meverden RA, Hodge DO, Uslan DZ, Hayes DL, Brady PA. Age and gender trends in implantable cardioverter defibrillator utilization: a population based study. J Interv Card Electrophysiol. 2008;22:65–70.

Camus C, Leport C, Raffi F, Michelet C, Cartier F, Vilde JL. Sustained bacteremia in patients with a permanent endocardial pacemaker: assessment of wire removal. Clin Infect Dis. 1993;17:46 –55.

Klug D, Lacroix D, Savoye C, Goullard L, Grandmougin D, Hennequin JL, et al. Systemic infection related to endocarditis on pacemaker leads: clinical presentation and management. Circulation.1997;95:2098 –2107.

Da Costa A, Lelièvre H, Kirkorian G, Célard M, Chevalier P, Vandenesch F, et al. Role of the preaxillary flora in pacemaker infections: a prospective study. Circulation. 1998;97:1791–5.

Fu EY, Shepard RK. Permanent pacemaker infections. Card Electrophysiol Rev. 1999;3:39–41.

Chua JD, Wilkoff BL, Lee I, Juratli N, Longworth DL, Gordon SM. Diagnosis and management of infections involving implantable electrophysiologic cardiac devices. Ann Intern Med. 2000;133:604–8.

Sohail MR, Uslan DZ, Khan AH, Friedman PA, Hayes DL, Wilson WR, et al. Management and outcome of permanent and implantable cardioverter-defibrillator infections. J Am Coll Cardiol. 2007;49:1851–9.

Villamil-Cajoto I, Rodríguez-Framil M, Van-den-Eynde-Collado A, José-Villacián-Vicedo M, Canedo-Romero C. Permanent transvenous pacemaker infections: an analysis of 59 cases. Eur J Intern Med. 2007;18:484–8.

del Rio A, Anguera I, Miró JM, Mont L, Fowler-VG Jr, Azqueta M, et al. Hospital Clinic Endocarditis Study Group. Surgical treatment of pacemaker and defibrillator lead endocarditis: the impact of electrode lead extraction on outcome. Chest. 2003;124:1451-9.

Kloos WE, Bannermann TL. Update on the clinical significance of coagulase-negative staphylococci. Clin Microbiol Rev. 1994;7:117–40.

Cacoub P, Leprince P, Nataf P, Hausfater P, Dorent R, Wechsler B, et al. Pacemaker infective endocarditis. Am J Cardiol. 1998;82:480–4.

Chacko ST, Chandy ST, Abraham OC, Swaminathan S, Varghese GM, Priscilla R. Pacemaker endocarditis caused by Pseudomonas aeruginosa treated successfully. JAPI. 2003;51:1021–2.

Amin M, Gross J, Andrews C, Furman S. Pacemaker infection with Mycobacterium avium complex. Pacing Clin Electrophysiol. 1991;14:152–4.

Giannella M, Valerio M, Franco J, Marin M, Bouza E, Muñoz P. Pacemaker infection due to Mycobacterium fortuitum: the role of universal 16S rRNA gene PCR and sequencing. Diagn Microbiol Infect Dis. 2007;57:337–9.

Arber N, Pras E,C opperman Y. Pacemaker endocarditis: report of 44 cases and review. Medicine (Baltimore). 1994;73:229-305.

Brook I. Clinical Infectious Disease.1997;24:1010-2.




DOI: https://doi.org/10.22037/nbm.v3i2.7807