Risk factors associated with early- versus late-onset implantable cardioverter-defibrillator infections

Sohail, M. Rizwan; Hussain, Salwa; Le, Katherine Y.; Dib, Chadi; Lohse, Christine M.; Friedman, Paul A.; Hayes, David L.; Uslan, Daniel Z.; Wilson, Walter R.; Steckelberg, James M.; Baddour, Larry M.

doi:10.1007/s10840-010-9537-x

Cited by 72 publications

(68 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In most cases, temporary pacing is chosen; however, presence of a temporary pacing lead is also associated with a higher infection risk. 19,37 Indwelling lines (e.g. central venous catheters and chest tubes) should be removed before CIED implantation.…”

Section: Before Implantationmentioning

confidence: 99%

See 1 more Smart Citation

Management of Cardiac Electronic Device Infections: Challenges and Outcomes

Kirkfeldt¹,

Johansen²,

Nielsen³

2016

Arrhythmia &Amp; Electrophysiology Review

View full text Add to dashboard Cite

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

show abstract

Section: Before Implantationmentioning

confidence: 99%

“…Most operators prefer >24 hours. Chronic skin conditions are associated with a higher infection risk 37 and should be appropriately treated before implant.…”

Section: Before Implantationmentioning

confidence: 99%

Management of Cardiac Electronic Device Infections: Challenges and Outcomes

Kirkfeldt¹,

Johansen²,

Nielsen³

2016

Arrhythmia &Amp; Electrophysiology Review

View full text Add to dashboard Cite

show abstract

“…The estimated rate of CDIs ranges from 0.13% to 20% (3)(4)(5). Older age, device revision, renal dysfunction, and oral anticoagulation use are known to be risk factors for CDIs (6,7). The identification of CDIs may be a challenge for physicians, due to the wide variety of presenting symptoms and the lack of a diagnostic "gold standard."…”

mentioning

confidence: 99%

“…Staphylococcal species, including both Staphylococcus aureus and coagulase-negative staphylococci, account for the majority of CDIs (7,9); however, unusual organisms (Propionibacterium spp., Corynebacterium spp., Acinetobacter baumannii, Haemophilus influenzae) are also found, and antibiotic resistance is often detected (10)(11)(12)(13). Moreover, there are data indicating that microorganisms can colonize cardiac devices without clinical signs of active infection (14)(15)(16).…”

mentioning

confidence: 99%

Sonication of Explanted Cardiac Implants Improves Microbial Detection in Cardiac Device Infections

et al. 2013

View full text Add to dashboard Cite

The sonication technique has been shown to be a promising tool for microbiological diagnosis of device-related infections. We evaluated the usefulness of the sonication method for pathogen detection in 80 explanted cardiac components collected from 40 patients, and the results were compared with those of conventional cultures. Forty subjects undergoing cardiac device removal were studied: 20 had cardiac device infection, and 20 subjects underwent elective generator replacement or revision in the absence of infection. Sonication of explanted devices was more sensitive than traditional culture for microbial detection (67% and 50%, respectively; P ‫؍‬ 0.0005). The bacterial count detected in sonication fluid culture was significantly higher than that detected in traditional culture in both infected (P ‫؍‬ 0.019) and uninfected (P ‫؍‬ 0.029) devices. In the infected patients, sonication fluid culture yielded a significantly higher rate of pathogen detection in explanted electrodes than traditional culture (65% versus 45%; P ‫؍‬ 0.02), while no differences were found in the generators. Ten strains were detected only through sonication fluid culture: 6 Staphylococcus epidermidis strains, 1 Staphylococcus hominis strain, 2 Corynebacterium striatum strains, and 1 Brevundimonas sp. Neither the type nor the duration of antimicrobial therapy before device removal had an effect on the diagnostic performance of sonication fluid culture (P ‫؍‬ 0.75 and P ‫؍‬ 0.56, respectively). In the patients without infection, sonication fluid culture was positive in 8 cases (40%), whereas conventional culture was positive in only 4 (20%). In summary, the sonication technique improves the microbiological diagnosis of explanted cardiac devices.

show abstract

“…[61] In addition, development of postoperative hematoma places the patient at elevated risk of device infection. [62] There is data to suggest that warfarin causes fewer pocket complications than heparin products. Specifically, temporarily interrupting anticoagulation is associated with increased thromboembolic events, whereas cessation of warfarin with bridging anticoagulation is associated with a higher rate of pocket hematoma and a longer hospital stay.…”

Section: Pocket Hematomamentioning

confidence: 99%