Implantation Success and Infection in Cardiovascular Implantable Electronic Device Procedures Utilizing an Antibacterial Envelope

Bloom, Heather; Constantin, Luis; DAN, DANIEL; Lurgio, David B. De; El-CHAMI, MIKHAIL; Ganz, Leonard I.; Gleed, Kent; Hackett, F K; Kanuru, Narendra; Lerner, Daniel J.; Rasekh, Abdi; Simons, Grant R.; Sogade, Felix; Sohail, M. Rizwan

doi:10.1111/j.1540-8159.2010.02931.x

Cited by 104 publications

(91 citation statements)

References 30 publications

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“…(13) This product is differentiated from others because it has already been tested in patients, with a 99% success rate. (14) Although some studies (11,12,19) have suggested that the combination of various antimicrobial agents as prophylaxis is effective in preventing infections by common agents, the frequent use of this therapy has increased the rates of resistance of microorganisms to the most-used antimicrobial agents. Although the use of rifampicin has been effective in reducing biofilm formation by Staphylococcus spp, it is necessary to rethink non-antibiotic measures to combat or prevent resistance, mainly to rifampicin.…”

Section: Discussionmentioning

confidence: 99%

“…(16) Staphylococci are the most frequently isolated pathogens of infections of implantable electronic cardiac devices, and 50%-75% of infections in CIED are caused by S. aureus and coagulase-negative Staphylococcus. (8,11,14) Staphylococcus spp. represents one of the most frequent causes of infections in healthcare settings.…”

Section: Discussionmentioning

confidence: 99%

“…The results showed that the pacemaker surfaces with antibacterial envelopes had reduced bacterial loads compared to the controls. Bloom (14) used the same type of antibacterial envelope to determine its potential in the prevention of infections associated with implantable electronic cardiac devices in humans. The research registered a high success rate, since there were only three cases of infection.…”

Section: Pharmacological Combination Of Antimicrobialsmentioning

confidence: 99%

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Prevenção da formação de biofilmes em marcapassos artificiais: é viável?

et al. 2017

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Objective: To identify the antimicrobial agents used in the prevention of biofilm formation on artificial pacemakers. Methods: Literature review, in order to answer the following question: "What antimicrobial agents are applied to prevent biofilm formation on artificial pacemakers?" The databases PubMed, Web of Science, Scopus, Science Direct, Cochrane, CINAHL, Embase, and LILACS were used in all languages and without time restriction. Results: The final sample consisted of five primary studies, mostly experimental laboratory ones. The investigations identified agents with promising potential for reduction or inhibition of biofilm formation on pacemakers. An association between physical-chemical agents and pharmacological antimicrobials was highlighted. Conclusion: Prevention of biofilm formation on pacemakers is feasible. Among the agents that stood out were rifampicin, AIGIS ® , aqueous neobactrim formulation, and a plasma coating using a combination of trimethylsilane and oxygen for coating deposition. ResumoObjetivo: Identificar os agentes antimicrobianos utilizados na prevenção da formação de biofilme em marcapassos artificiais. Métodos: Revisão da literatura para responder a seguinte questão: "Quais agentes antimicrobianos são usados para prevenir a formação de biofilmes em marcapassos artificiais?" As bases de dados PubMed, Web of Science, Scopus, Science Direct, Cochrane, CINAHL, Embas e e LILACS foram consultadas em todos os idiomas sem restrição de tempo. Resultados: A amostra final apresentou cinco estudos primários, sendo a maioria experimental. As investigações identificaram agentes com potencial para a redução ou inibição da formação de biofilmes em marcapassos. Destacou-se a associação de agentes físico-químicos e farmacológicos aos agentes antimicrobianos. Conclusão: A prevenção da formação de biofilmes em marcapassos é viável. Os agentes mais promissores para obter este efeito foram a rifampicina, AIGIS ® , a formulação aquosa neobactrim e a cobertura com trimetilsilano e oxigênio em superfícies tratadas com plasma.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Pharmacological Combination Of Antimicrobialsmentioning

confidence: 99%

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Prevenção da formação de biofilmes em marcapassos artificiais: é viável?

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“…This envelope eliminates staphylococcal species and prevents biofilm formation on implanted pacing devices in animal studies, 44 and reduces CIED infections in high-risk patients in observational studies. [45][46][47] The most recent version is bio-absorbable and disappears within 9 weeks after implantation. In a single-centre observational study including 1,124 high-risk patients, infection …”

Section: Peri-operativementioning

confidence: 99%

Management of Cardiac Electronic Device Infections: Challenges and Outcomes

Kirkfeldt¹,

Johansen²,

Nielsen³

2016

Arrhythmia &Amp; Electrophysiology Review

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Cardiac implantable electronic device (CIED) infection is an increasing problem. Reasons for this are uncertain, but likely relate to an increasing proportion of implantable cardioverter defibrillator (ICD) and cardiac resynchronisation therapy (CRT) devices implanted, as well as implantations in ‘higher risk’ candidates, i.e. patients with heart failure, diabetes and renal failure. Challenges within the field of CIED infections are multiple with prevention being the most important challenge. Careful prescription of CIED treatment and careful patient preparation before implantation is important. Diagnosis is often difficult and delayed by subtle signs of infection. Treatment of CIED infection includes complete system removal in centres experienced in CIED extraction and prolonged antibiotic therapy. Meticulous planning and preparation before system extraction and later CIED re-implantation is essential for better patient outcome. Future strategies for reducing CIED infection should be tested in sufficiently powered, multicentre, randomised controlled trials

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“…The TYRX™ non-absorbable envelope (Medtronic) has shown substantial efficacy in clinical studies in reducing the infection rate. 23,79,80 This has led to the development of the TYRX absorbable envelope, which is constructed from a fully bioabsorbable multifilament mesh (see Figure 4). The envelope holds the CIED in place, preventing device migration, elutes antimicrobial agents minocycline and rifampicin for a minimum of 7 days; and then is fully absorbed approximately 9 weeks after implantation.…”

Section: Strategies To Prevent Cardiac Implantable Electronic Device mentioning

confidence: 99%

Cardiac Implantable Electronic Device Infection in Patients at Risk

Tarakji

Ellis

Defaye

et al. 2016

Arrhythmia &Amp; Electrophysiology Review

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Device TherapyOver the last few decades an increasing body of evidence has supported the role of cardiovascular implantable electronic devices However, the cost and complications of device implantation, including infection or hardware malfunction in patients receiving CIEDs, have led to the concern that negative outcomes may partially counteract the expected benefits. The rate of CIED infection has been estimated at 0.5 % with primary implants and 1-7 % with secondary interventions.3,5-8 It is difficult to give accurate estimates of infection rates, given the fact that figures are partly based on retrospective series of varying duration, and that different definitions of infection exist. However, the incidence of CIED infection is increasing out of proportion to CIED implantation. 3,5,9 A US study reported a 12 % increase in the number of CIED implantations from 2004 to 2006, with a 57 % increment in CIED infections during the same period. 9Reasons for this rise in CIED infections include the fact that younger patients are receiving CIEDs, and therefore surviving long enough to require more pulse generator changes and lead revisions, which are associated with a higher infection rate. 7,10 In addition, there has been an increase in comorbidities, such as diabetes and kidney disease, resulting in poor wound healing and diminished immune responses. 3,9,11,12 Expanding indications for CIED use, coupled with an ageing population with more comorbidities, mean this trend is likely to increase.2 Better awareness and improved reporting of CIED infections may, however, help to decrease the higher complication rates noted in recent years.CIED infections also impose a substantial financial burden resulting from prolonged hospital stays, long duration of antibiotic therapy, management of sepsis and complications, device extraction and reimplantation.3 These infections typically cost at least $52,000 13 and may exceed $100,000. 14 This article will review strategies for management and prevention of CIED infections, including lead extraction and the use of an absorbable antibacterial envelope. Risk Factors for Cardiac Implantable Electronic Device Infections

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Implantation Success and Infection in Cardiovascular Implantable Electronic Device Procedures Utilizing an Antibacterial Envelope

Abstract: CIED procedures that utilized an antibacterial envelope had a high rate of CIED implantation success (>99%). Although the follow-up to date is short, there was also a low rate of infection (<0.50%) in this population at high risk for CIED infection.

Cited by 104 publications

References 30 publications

Prevenção da formação de biofilmes em marcapassos artificiais: é viável?

Prevenção da formação de biofilmes em marcapassos artificiais: é viável?

Management of Cardiac Electronic Device Infections: Challenges and Outcomes

Cardiac Implantable Electronic Device Infection in Patients at Risk

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