Atypical pathogens associated with cardiac implantable electronic device infections.

Publisher: Futura Pub. Co. Country of Publication: United States NLM ID: 7803944 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1540-8159 (Electronic) Linking ISSN: 01478389 NLM ISO Abbreviation: Pacing Clin Electrophysiol Subsets: MEDLINE

Original Publication: Mount Kisco, N. Y. : Futura Pub. Co., c1978-

Device Removal*; Anti-Bacterial Agents/*therapeutic use ; Defibrillators, Implantable/*adverse effects ; Pacemaker, Artificial/*adverse effects ; Prosthesis-Related Infections/*microbiology ; Prosthesis-Related Infections/*therapy; Aged ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged

Background: Cardiovascular implantable electronic device (CIED) infections are associated with significant morbidity and mortality making the identification of the causative organism critical. The vast majority of CIED infections are caused by Staphylococcal species. CIED infections associated with atypical pathogens are rare and have not been systematically investigated. The objective of this study is to characterize the clinical course, management and outcome in patients with CIED infection secondary to atypical pathogens.
Methods: Medical records of all patients who underwent CIED system extraction at the University of Chicago Medical Center between January 2010 and November 2020 were retrospectively reviewed to identify patients with CIED infection. Demographic, clinical, infection-related and outcome data were collected. CIED infections were divided into typical and atypical groups based on the pathogens isolated.
Results: Among 356 CIED extraction procedures, 130 (37%) were performed for CIED infection. Atypical pathogens were found in 5.4% (n = 7) and included Pantoea species (n = 2), Kocuria species (n = 1), Cutibacterium acnes (n = 1), Corynebacterium tuberculostearicum (n = 1), Corynebacterium striatum (n = 1), Stenotrophomonas maltophilia (n = 1), and Pseudozyma ahidis (n = 1). All patients with atypical CIED infections were successfully treated with total system removal and tailored antibiotic therapy. There were no infection-related deaths.
Conclusions: CIED infections with atypical pathogens were rare and associated with good outcome if diagnosed early and treated with total system removal and tailored antimicrobial therapy. Atypical pathogens cultured from blood, tissue or hardware in patients with CIED infection should be considered pathogens and not contaminants.
(© 2021 The Authors. Pacing and Clinical Electrophysiology published by Wiley Periodicals LLC.)

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Keywords: atypical microorganisms; cardiac implantable electronic device infection; lead extraction

0 (Anti-Bacterial Agents)

Date Created: 20210710 Date Completed: 20220131 Latest Revision: 20220731

20250114

PMC9290787

10.1111/pace.14311

34245025