The Diagnosis and Treatment of Pacemaker-Associated Infection

Doering, Michael; Richter, Sergio; Hindricks, Gerhard

doi:10.3238/arztebl.2018.0445

Cited by 36 publications

(39 citation statements)

References 57 publications

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“…Infected foreign bodies incl. vascular catheters or cardiac electronic devices have to be removed quickly and completely in addition to an adequate antibiotic treatment ( 20 , 21 ). If vascular catheters have been in situ during bacteremia, a removal should be considered even if another site is suspected as focus of the SA-BSI since catheters remain the most frequent primary source of infection and moreover there is a high risk of secondary catheter colonization ( 22 – 25 ).…”

Section: Current Diagnostic and Treatment Standardsmentioning

confidence: 99%

Management of Staphylococcus aureus Bloodstream Infections

et al. 2021

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Staphylococcus aureus bloodstream infections are associated with a high morbidity and mortality. Nevertheless, significance of a positive blood culture with this pathogen is often underestimated or findings are misinterpreted as contamination, which can result in inadequate diagnostic and therapeutic consequences. We here review and discuss current diagnostic and therapeutic key elements and open questions for the management of Staphylococcus aureus bloodstream infections.

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Section: Current Diagnostic and Treatment Standardsmentioning

confidence: 99%

Management of Staphylococcus aureus Bloodstream Infections

et al. 2021

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“…A more than two-fold increased risk of acquiring infections is associated with the cardiac device implantation, replacement, and repair surgeries. It is important to identify patients at risk, diagnose the infection using pathogen detection in blood cultures, and finding pathogen biofilms by imaging techniques and initiate appropriate and specific antimicrobial therapy to minimize the morbidity and mortality associated with IAIs [42][43][44].…”

Section: Infection Control and Preventive Measuresmentioning

confidence: 99%

Implant-Associated Infections: A Review of the Safety of Cardiac Implants

Kandi¹,

Vadakedath²

2020

Cureus

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“…On the part of the manufacturers, important indicators are the air volume and filtration performance of the packaging against bacterial spores, which are measured by exposure of the packaging to bacterial spores in an aerosol. For this, the test conditions with regard to flow-through rate, microbe content, and duration of test must be standardized (1). The manufacturer's statements regarding these parameters are very incomplete, and the incomplete data situation prevents the microbe load from being calculated.…”

Section: In Replymentioning

confidence: 99%

Monitoring Sterile Pacemaker Implants

Dunkelberg¹

2018

Deutsches Ärzteblatt International

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Recommendations for performing cardiac electronic implantation emphasize strict compliance with comprehensive hygiene regulations (1). The theoretical probability of an unsterile product must not be greater than 1:1 000 000. However, how the high standards of quality and sterility of the applied products can be ensured up to the point of use remains an open question.The components of sterile packaging have to be gas permeable in order to allow sterilants, such as superheated steam or ethylene oxide, access to the sterile products. Filter performance must compensate for airborne microbial challenge caused by air pressure and temperature variations during transport and storage. Analogous to the sterilization procedure, process evaluation for sterile product storage is necessary to provide data support for ensuring the required high level of quality.An increase in air pressure of 15 hPa, for example, causes an air inflow of 15 mL in a 1 L packaging volume. Assuming a filtration performance of 99% and an airborne microbial load of 500 microbes per cubic meter, about 75 of 1 000 000 sterile products will be contaminated, which exceeds the sterility assurance level by 75-fold. An increase in the likelihood of nonsterility, for instance to 1:1000 in clinical epidemiological studies, would not be expected to yield significant results. However, it violates international standards and is incompatible with aseptic procedures. According to manufacturers' instructions and some studies, filtration performance of various sterile product packagings with respect to airborne micro-organisms differs considerably (2,3). In a study funded by seven producers, the filtration performance of the sixteen tested products was mostly between 90% and 99%, with the maximum difference factor at 50 000 (3).With an annual 105 000 primary implantations in Germany, a postoperative infection rate of 1%, and a hospital mortality of 5% to 15%, data-based monitoring for maintaining sterility should be a priority (1).

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The Diagnosis and Treatment of Pacemaker-Associated Infection

Abstract: Untreated infection carries a high mortality. Evaluation and treatment according to a standardized clinical algorithm facilitate correct and timely diagnosis and the choice of an appropriate therapeutic strategy.

Cited by 36 publications

References 57 publications

Management of Staphylococcus aureus Bloodstream Infections

Management of Staphylococcus aureus Bloodstream Infections

Implant-Associated Infections: A Review of the Safety of Cardiac Implants

Monitoring Sterile Pacemaker Implants

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