Prevention of pacemaker infections with perioperative antimicrobial treatment: an in vitro study

Marsch, Georg; Mashaqi, Bakr; Burgwitz, Karin; Bisdas, Theodosios; Knigina, Ludmilla; Stiesch, Meike; Haverich, Axel; Kuehn, C.

doi:10.1093/europace/eut222

Cited by 13 publications

(14 citation statements)

References 36 publications

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“…Although new technologies make implantation easier, the number of infections related to CIED has doubled in the past two decades, to the point that some scholars claim that infection rates associated with CIED have increased faster than the number of implantations, resulting in increased morbidity, mortality and expenses to the system. (8) In addition to the repercussions for infections, the currently available treatment measures are "radical" and make the picture even more dramatic for patients, since complete removal of the entire device, coupled with antibiotic treatment for several weeks, remains the single viable therapy. (8,15) Additionally, if removal of the infected implant is not feasible, patients must depend exclusively on antibiotic drug therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Another study (8 ) aimed to evaluate the biocompatibility and efficacy of various antimicrobial agents in the prevention of bacterial adhesion to biofilm formation on cardiac devices. The devices were impregnated with seven different solutions of antimicrobial agents (five antibiotics and two antiseptics).…”

Section: Pharmacological Combination Of Antimicrobialsmentioning

confidence: 99%

“…These infections commonly occur in the source store (also called the pacemaker store), and their evolution present high morbidity and mortality, since the only effective treatment is mechanical removal of the biofilm and replacement of the old device with a new one. (8,9) The aggressiveness of the available treatment reinforces the need for biofilm prevention measures, such as using pacemakers that have been impregnated or coated with antimicrobial substances. The antimicrobial agents act on the initial stage of microbial adhesion to the substrate, before production of the EPS and irreversible biofilm.…”

Section: Introductionmentioning

confidence: 99%

“…The antimicrobial agents act on the initial stage of microbial adhesion to the substrate, before production of the EPS and irreversible biofilm. (8,10) However, there is no standardization of these practices, which hinders their clinical application and reinforces the need for the current study.…”

Section: Introductionmentioning

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: Pharmacological Combination Of Antimicrobialsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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“…71,72 In addition, the antimicrobial treatment of pacemaker casings with antiseptics has been investigated in vitro and early studies showed promising results. 73 The most common strategy to reduce infections is intravenous prophylaxis using antibiotics. 74 A double-blind clinical trial randomised patients (n=649) to prophylactic antibiotics (intravenous administration of 1 g cefazolin immediately before the procedure) or placebo.…”

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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A Roadmap for Reducing Cardiac Device Infections: a Review of Epidemiology, Pathogenesis, and Actionable Risk Factors to Guide the Development of an Infection Prevention Program for the Electrophysiology Laboratory

Branch‐Elliman

2017

Curr Infect Dis Rep

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Basic prevention practices, such as administration of systemic antimicrobials prior to incision and delaying the procedure in the setting of fever or elevated INR, are helpful for day-to-day prevention of cardiac device infections. Small single-center studies provide proof-of-concept that bundled prevention interventions can reduce infections, particularly in outbreak settings. However, data regarding which prevention strategies are the most important is limited as are data regarding the optimal prevention program for day-to-day prevention (Borer et al. Infect Control Hosp Epidemiol 25(6):492-7 2004; Ahsan et al. Europace 16(10):1482-9 2014). Evolution of infection prevention programs to include ambulatory and procedural areas is crucial as healthcare delivery is increasingly provided outside of hospitals and operating rooms. The focus on traditional operating rooms and inpatient care leaves the vast majority of healthcare delivery-including cardiac device implantations in the electrophysiology laboratory-uncovered.

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Prevention of pacemaker infections with perioperative antimicrobial treatment: an in vitro study

Cited by 13 publications

References 36 publications

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

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

Cardiac Implantable Electronic Device Infection in Patients at Risk

A Roadmap for Reducing Cardiac Device Infections: a Review of Epidemiology, Pathogenesis, and Actionable Risk Factors to Guide the Development of an Infection Prevention Program for the Electrophysiology Laboratory

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