Identification of causative organism in cardiac implantable electronic device infections

Fukunaga, Masato; Goya, Masahiko; Nagashima, Michio; Hiroshima, Kenzo; Yamada, Takashi; An, Yoshimori; Hayashi, Kentarō; Makihara, Yu; Ohe, Masatsugu; Ichihashi, Kei; Ohtsuka, Morimasa; Mitsuya, Hiroaki; Ando, Kenji

doi:10.1016/j.jjcc.2017.03.006

Cited by 16 publications

(25 citation statements)

References 19 publications

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“…Over recent years, the growing use of CIEDs has led to an increase in the incidence of IE due to difficult-to-treat organisms, such as methicillin- resistant Staphylococcus aureus, Candida spp., and GNB (19)(20)(21)(22). It has been documented that a significant percentage of device-related IE cases (from 16% to 23%) are caused by non-Staphylococcus species (23,24), represented mostly by GNB, with a predominance of Pseudomonas aeruginosa (24). It has also been demonstrated that, in contrast to the pattern for infections with Gram-positive bacteria, among patients with CIED-related IE, the GNB isolated from the pocket or infected skin tissue is highly concordant with the strain isolated from the bloodstream (23).…”

Section: Discussionmentioning

confidence: 99%

Risk Factors and Outcomes of Endocarditis Due to Non-HACEK Gram-Negative Bacilli: Data from the Prospective Multicenter Italian Endocarditis Study Cohort

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Durante‐Mangoni

et al. 2018

Antimicrob Agents Chemother

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The objective of this study was to investigate predisposing factors and outcomes of infective endocarditis (IE) caused by non-HACEK Gram-negative bacilli (GNB) in a contemporary multicenter cohort. Patients with IE due to GNB, prospectively observed in 26 Italian centers from 2004 to 2011, were analyzed. Using a case-control design, each case was compared to three age- and sex-matched controls with IE due to other etiologies. Logistic regression was performed to identify risk factors for IE due to GNB. Factors associated with early and late mortality were assessed by Cox regression analysis. The study group comprised 58 patients with IE due to GNB. We found that was the most common pathogen, followed by and The genitourinary tract as a source of infection (odds ratio [OR], 13.59; 95% confidence interval [CI], 4.63 to 39.93; < 0.001), immunosuppression (OR, 5.16; 95% CI, 1.60 to 16.24; = 0.006), and the presence of a cardiac implantable electronic device (CIED) (OR, 3.57; 95% CI, 1.55 to 8.20; = 0.003) were factors independently associated with IE due to GNB. In-hospital mortality was 13.8%, and mortality rose to 30.6% at 1 year. A multidrug-resistant (MDR) etiology was associated with in-hospital mortality (hazard ratio [HR], 21.849; 95% CI, 2.672 to 178.683; = 0.004) and 1-year mortality (HR, 4.408; 95% CI, 1.581 to 12.287; = 0.005). We conclude that the presence of a genitourinary focus, immunosuppressive therapy, and an indwelling CIED are factors associated with IE due to GNB. MDR etiology is the major determinant of in-hospital and long-term mortality.

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Section: Discussionmentioning

confidence: 99%

Risk Factors and Outcomes of Endocarditis Due to Non-HACEK Gram-Negative Bacilli: Data from the Prospective Multicenter Italian Endocarditis Study Cohort

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Tiseo

Durante‐Mangoni

et al. 2018

Antimicrob Agents Chemother

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“…CIED infections are an unfortunate but not unexpected risk, estimated to be approximately 0.5% to 1% for first-time implantation and 1%–5% for replacement or upgrade 7. The most common causative organisms of CIED infection are consistently identified as Staphylococcus aureus and coagulase-negative staphylococci 7 16. A 2017 Cleveland Clinic Journal of Medicine report indicated that mycobacterial infections represented just 0.2% of their pacemaker infections in contrast to 68.4% caused by Staphylococcus and 8.9% caused by gram-negative organisms 7.…”

Section: Discussionmentioning

confidence: 99%

Rare case of pacemaker infection withMycobacterium abscessus

Radigan¹,

Jevert-Eichorn

2019

BMJ Case Rep

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Though prevalent in the environment, nontuberculous mycobacteria (NTM) have been increasingly identified as pathogenic. Sporadic reports of NTM infection of cardiac implantable electronic devices (CIEDs) have appeared but remain rare. This case describes a CIED infection with Mycobacterium abscessus, the third reported case in the literature. A 63-year-old male presented with a 3-day history of drainage from his pacemaker extraction site. An aspirate grew Mycobacterium abscessus. Together with National Jewish Health, a treatment plan was developed, consisting of an induction phase with amikacin, cefoxitin and clarithromycin followed by a maintenance phase with clarithromycin and clofazimine. The clinical course was complicated by cardiac arrhythmia, abscess formation and thoracic osteomyelitis with epidural abscess. This case highlights a rare manifestation of Mycobacterium abscessus disease and suggests the need for further study. Treatment is complicated by unpredictable resistance patterns, complex antimicrobial regimens and the use of arrhythmogenic medications in patients with removed CIEDs.

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“…Infective endocarditis is a serious infectious disease with high associated morbidity and mortality. Identification of the causative agents is, therefore, crucial for improving the clinical outcome [1]. Clinically, infective endocarditis is generally diagnosed based on positive blood cultures, removed leads, and/or infected pocket material [1].…”

Section: Introductionmentioning

confidence: 99%

“…Identification of the causative agents is, therefore, crucial for improving the clinical outcome [1]. Clinically, infective endocarditis is generally diagnosed based on positive blood cultures, removed leads, and/or infected pocket material [1]. Species belonging to the genera Streptococcus, Staphylococcus, and Enterococcus are the primary causative organisms of infective endocarditis [2].…”

Section: Introductionmentioning

confidence: 99%

Characterization and whole genome sequencing of a novel strain of Bergeyella cardium related to infective endocarditis

Sun

Zhang

2020

BMC Microbiol

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Background: Bergeyella cardium infection is becoming increasingly prevalent in patients with infective endocarditis, suggesting its significance in disease pathogenesis. However, few studies have fully characterized this species. Results: Herein, we report the morphological and physiological characteristics, as well as whole genome sequencing of a newly identified B. cardium HPQL strain isolated from a patient with infective endocarditis. Results from the cellular morphology and biochemical analysis provide basic knowledge on the new pathogen. The whole genome sequencing of B. cardium HPQL consists of a circular chromosome with a total length of 2,036,890 bp. No plasmid was detected. Comparative genomics were carried out then. Antibiotics resistance related genes, pathogenesis related genes, predicted insertion sequences, genome islands and predicted CRISPRs sequences were demonstrated. To our knowledge, this is the first study to provide a complete genome sequence for Bergeyella spp.Conclusions: This study provides fundamental phenotypic and genomic information for the newly identified fastidious infective endocarditis causative bacteria, B. cardium. Our results provide insights into effective clinical diagnosis and treatment of this pathogen.

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Identification of causative organism in cardiac implantable electronic device infections

Abstract: The causative organism is mostly S. aureus and CoNS. Detection of S. aureus or Gram-negative bacteria means that it is more likely a causative organism.

Cited by 16 publications

References 19 publications

Risk Factors and Outcomes of Endocarditis Due to Non-HACEK Gram-Negative Bacilli: Data from the Prospective Multicenter Italian Endocarditis Study Cohort

Risk Factors and Outcomes of Endocarditis Due to Non-HACEK Gram-Negative Bacilli: Data from the Prospective Multicenter Italian Endocarditis Study Cohort

Rare case of pacemaker infection withMycobacterium abscessus

Characterization and whole genome sequencing of a novel strain of Bergeyella cardium related to infective endocarditis

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