Influence of the type of pathogen on the clinical course of infectious complications related to cardiac implantable electronic devices

Polewczyk, Anna; Jacheć, Wojciech; Segreti, Luca; Bongiorni, Maria Grazia; Kutarski, Andrzej

doi:10.1038/s41598-021-94168-7

Cited by 5 publications

(6 citation statements)

References 37 publications

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“…1 , 12 Mortality for AICD infection vs patients without infection at 3-year follow-up was recently reported to be 47.7% and 31.6%, respectively. 2 In addition the highest rate of mortality was found in patients with gram positive infections caused by non-staphylococcus organisms. 2 While Gemella was not specifically addressed, it is a Gram-positive species other than staphylococcus with limited data on treatment and needs to be studied to determine its mortality.…”

Section: Discussionmentioning

confidence: 99%

“…2 In addition the highest rate of mortality was found in patients with gram positive infections caused by non-staphylococcus organisms. 2 While Gemella was not specifically addressed, it is a Gram-positive species other than staphylococcus with limited data on treatment and needs to be studied to determine its mortality. Given the absence of data concerning lead infection by this organism and inability to do susceptibility testing at our facility, our treatment course was derived from case reports and guidelines on infective endocarditis in addition to cardiac device removal.…”

Section: Discussionmentioning

confidence: 99%

“…1 While Staphylococcus aureus is the most prevalent organism, the highest rate of mortality was found in patients with Gram-positive infections caused by non-staphylococcus organisms. 2 Due to this association, it is important to document and understand rare causes of implantable cardiac devices and their treatment.…”

Section: Introductionmentioning

confidence: 99%

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Gemella haemolysans: Rare case of automatic implantable cardioverter-defibrillator (AICD) lead infection

Kriege

Wilson

Tate

2022

SAGE Open Medical Case Reports

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We present a rare case of Gemella haemolysans automated implantable cardioverter defibrillator (AICD) lead infection. Gemella species are catalase-negative, facultative anaerobic, Gram-positive cocci which are found in normal human oral flora. Gemella are often incorrectly identified on routine Gram stain and culture, requiring advanced techniques such as PCR. Gemella has been shown to be a rare cause infective endocarditis in case reports; however, there has not been a report of an isolated AICD lead infection. AICD infections with gram positive organisms other than Staphylococcus species has been associated with more aggressive infections and higher mortality. Standard treatment for Gemella consists of β-lactam inhibitors and aminoglycosides. In this case, we present an alternative antibiotic treatment with vancomycin and ceftriaxone. A case series for Gemella haemolysans endocarditis, without lead infection, reported the use of vancomycin and ceftriaxone with good results. This approach is similar to methicillin-resistant staphylococcus aureus (MRSA) bacteremia salvage therapy. In addition, this case highlights the importance of culture and sensitivity in the selection of antibiotics, particularly avoiding nephrotoxic drugs when possible.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Gemella haemolysans: Rare case of automatic implantable cardioverter-defibrillator (AICD) lead infection

Kriege

Wilson

Tate

2022

SAGE Open Medical Case Reports

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“…∼26,000 TRY [30] Cardiac implantable electronic devices ∼1.2-3.6% [31] Staphylococcus aureus (MSSA and MRSA), Staphylococcus epidermidis (MSSE and MRSE), other CoNS, other Grampositive cocci, GNB, Candida and Aspergillus (fungi) [32] . Intervention [33]: Removal of all CIED hardware and prolonged intravenous antibiotics…”

Section: Introductionmentioning

confidence: 99%

“…Indwelling medical devices are particularly sensitive to biofilm formation as they are inherently ‘foreign bodies’, which trigger an inflammatory reaction in reducing the immune response locally around the implant, while at the same time providing an ideal substratum for microbial adhesion [32]. Therefore, prevention of the initial microbial contamination is the first important step in the battle against MDIs.…”

Section: Introductionmentioning

confidence: 99%

Biomaterial strategies to combat implant infections: new perspectives to old challenges

Braem

Kamarudin

Bhaskar

et al. 2023

International Materials Reviews

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Peri-implant infection is rapidly becoming anif not the mostimportant clinical challenge for indwelling medical devices. To alleviate the global rise in antibiotic use for the treatment of such infections, a plethora of biomaterials/bioengineering-based antimicrobial strategies are emerging to restrict or ideally to eliminate microbial adhesion and biofilm formation on implant surfaces. Yet, the development of such approaches faces specific challenges, like biocompatibility concerns, reduced antimicrobial effectiveness, long-term stability issues and antibiotic resistance development, which limit translation to the clinic. This review provides insights into the antimicrobial activity of current state-of-the-art biomaterial-based approaches to address the aforementioned issues. Translational research strategies and regulatory framework are also emphasised as key elements facilitating clinical implementation of anti-infective biomaterials. This review closes with the vision that the integration of computational tools and experimental databases using artificial intelligence (AI) would provide new insights for the accelerated development of next-generation biomaterial-based antimicrobial strategies.

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“Not much room for mushrooms” in the heart: knowns and unknowns of fungal infective endocarditis

Mistiaen

2024

Vessel Plus

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Fungal infective endocarditis is a rare but highly lethal condition. Its diagnosis is often delayed due to nonspecific symptoms, inconclusive medical imaging, and negative blood cultures. Recent reviews of cases and series over the last 5 years indicate that the condition remains rare and lethal. If fungi are identified as the causative agents in more than 5% of patient cases with infective endocarditis, it is likely that risk factors such as immune suppression or cardiac implants are probably involved. A series derived from recent case reports indicates that Candida and Aspergillus are still the main causative infectious agents, with. C parapsilosis on the rise. From these cases, diagnostic clues (frequent embolisms, ophthalmic involvement, large, mobile and friable vegetation, non-valvular cardiac manifestations) are pointing towards fungal IE. These reports, however, are not standardized and a publication bias towards rare microorganisms or towards a favorable outcome might exist. Complications might be underreported, and important data such as diagnostic delay are absent or difficult to retrieve. Pharmacologic treatment is not fully standardized. Knowledge of resistant strains in this respect is important. Statistical analysis for the effect of complications and treatment modalities on outcome shows that any result should be treated cautiously. The current series is by no means a valid substitute for a well-designed series of fungal endocarditis. However, the better outcome with Candida and patients treated with surgery confirm earlier results. An international multicentric standardized registry of cases with fungal endocarditis in order to improve the outcome of this disease is highly needed. The effect of diagnostic delay on outcome remains elusive and should be resolved.

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Influence of the type of pathogen on the clinical course of infectious complications related to cardiac implantable electronic devices

Cited by 5 publications

References 37 publications

Gemella haemolysans: Rare case of automatic implantable cardioverter-defibrillator (AICD) lead infection

Gemella haemolysans: Rare case of automatic implantable cardioverter-defibrillator (AICD) lead infection

Biomaterial strategies to combat implant infections: new perspectives to old challenges

“Not much room for mushrooms” in the heart: knowns and unknowns of fungal infective endocarditis

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