Microbiological Characteristics and Clinical Features of Cardiac Implantable Electronic Device Infections at a Tertiary Hospital in China

Abstract

The incidence of cardiac implantable electronic device (CIED) infections is rapidly increasing worldwide. However, the microbiological characteristics and clinical features of symptomatic CIED infections are not well described. The present study included patients with CIED infections in China, and their pocket tissues were collected for clinical microbiological determination. A total of 219 patients with CIED infections were investigated; of these patients, 145 (66.2%) were positive for CIED infection in pocket tissue cultures and 24 (11.0%) were positive in both blood and pocket tissue cultures. Patients with recurrent infections and patients with systemic infections tended to have higher rates of positive cultures from pocket tissue. In addition, patients with lung diseases were more likely to have early CIED infections than late CIED infections, while patients with liver diseases were more susceptible to systemic infections than local infections. Staphylococcus species were the most common cause of CIED infections; coagulase-negative staphylococci was the predominant type (accounting for 45.2% in all cases and 68.3% in culture-positive cases). None of the Staphylococcus isolates were resistant to gentamicin, linezolid or vancomycin. Gram-negative bacilli accounted for 9.1% of all cases and 13.8% of culture-positive cases. Significant differences in the distribution of different pathogens were identified between primary infections and recurrent infections, between local infections and systemic infections, and between early infections and late infections. Our data describe the microbiological characteristics and clinical features of CIED infections, and provide evidence for advisory guidelines on the management of CIED infections in China.

Cardiac implantable electronic device infection in the cardiac referral center in Thailand: incidence, microbiology, risk factors, and outcomes

“…Most of the positive culture in this study were gram‐positive organisms similar to western countries, but in a lower proportion (44.4% vs 68%‐93%) . CoNS, which are one of the normal skin flora, were the most frequent cause of the CIED infections, indicating that most CIED infections were inoculated at the time of implantations . Although monomicrobial gram‐negative CIED infection composed only 11.1% in this study, all polymicrobial CIED infection patients, composed of gram‐negative bacilli.…”

“…3 CoNS, which are one of the normal skin flora, were the most frequent cause of the CIED infections, indicating that most CIED infections were inoculated at the time of implantations. 28,35,36 Although monomicrobial gram-negative CIED infection composed only 11.1% in this study, all polymicrobial CIED infection patients, composed of gram-negative bacilli. Two episodes (3.7%) of…”

“…However, data on microbiology of CIED infection in Asian countries are limited. Studies from Japan and China showed that Staphylococcus remained the predominant pathogen associated with CIED infection …”

“…Studies from Japan and China showed that Staphylococcus remained the predominant pathogen associated with CIED infection. [26][27][28] In Thailand, CIED implantation has been increasingly performed.…”

Preclinical evaluation of efficacy and pharmacokinetics of gentamicin containing extracellular‐matrix envelope

“…Gentamicin is an aminoglycoside with broad‐spectrum bactericidal activity including the most common organisms identified in CIED infections including Staphylococcus spp. and aerobic Gram‐negative organisms 22–25 . When given as monotherapy, gentamicin has also demonstrated in vitro efficacy against established Staphyloccocal biofilms 26 .…”