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Cied infection

Jean-François Sarrazin, François Philippon, Mikaël Trottier, Michel Tessier
Cardiovascular implantable electronic device (CIED) infection and prosthetic valve endocarditis (PVE) remain a diagnostic challenge. Cardiac imaging plays an important role in the diagnosis and management of patients with CIED infection or PVE. Over the past few years, cardiac radionuclide imaging has gained a key role in the diagnosis of these patients, and in assessing the need for surgery, mainly in the most difficult cases. Both (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) and radiolabelled white blood cell single-photon emission computed tomography/computed tomography (WBC SPECT/CT) have been studied in these situations...
September 26, 2016: World Journal of Cardiology
K-H Song, S-I Jung, S Lee, S Park, S M Kiem, S H Lee, Y G Kwak, Y K Kim, H-C Jang, Y-S Kim, H-I Kim, C J Kim, K-H Park, N J Kim, M-D Oh, H B Kim
Cefazolin treatment failure has been observed in high-inoculum infections caused by methicillin-susceptible Staphylococcus aureus (MSSA) with a cefazolin inoculum effect (CIE). However, data on the characteristics and risk factors for the acquisition of CIE-positive MSSA infection are scarce. CIE positivity was measured as an MIC ≥ 16 μg/ml with a high inoculum (∼5 × 10(7) CFU/ml). The blaZ gene type was assessed through sequence analysis. The clinical characteristics and risk factors for the acquisition of CIE-positive MSSA infection were assessed...
October 6, 2016: European Journal of Clinical Microbiology & Infectious Diseases
Mohammed A Al-Hijji, Ammar M Killu, Omid Yousefian, David O Hodge, Jae Yoon Park, Shrinivas Hebsur, Abdallah El Sabbagh, Victor G Pretorius, Michael J Ackerman, Paul A Friedman, Ulrika Birgersdotter-Green, Yong-Mei Cha
AIMS: Outcomes among patients who do not receive device reimplantation after cardiovascular implantable electronic device (CIED) extraction have not been well studied. The present study aims to investigate the outcomes of patients without device reimplantation after lead extraction and device removal. METHODS AND RESULTS: We retrospectively searched for consecutive patients who underwent CIED extraction at Mayo Clinic, Rochester, MN and University of California San Diego Medical Center from 2001 through 2012...
October 5, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Khaldoun G Tarakji, Suneet Mittal, Charles Kennergren, Ralph Corey, Jeanne Poole, Kurt Stromberg, Daniel R Lexcen, Bruce L Wilkoff
BACKGROUND: Cardiac implantable electronic device (CIED) infection is a major complication that is associated with significant morbidity and mortality. The aim of this study is to determine whether Medtronic TYRX absorbable envelope reduces the risk of CIED infection through 12 months of follow-up post procedure. METHODS: WRAP-IT is a randomized, prospective, multi center, international, single-blinded study. Up to 7,764 subjects who are undergoing CIED generator replacement, upgrade, or revision, or a de novo CRT-D implant, will be enrolled and randomized (1:1) to receive the TYRX envelope or not...
October 2016: American Heart Journal
Xin-Miao Huang, Hai-Xia Fu, Li Zhong, Jiang Cao, Samuel J Asirvatham, Larry M Baddour, M Rizwan Sohail, Vuyisile T Nkomo, Rick A Nishimura, Kevin L Greason, Rakesh M Suri, Paul A Friedman, Yong-Mei Cha
BACKGROUND: Lead-related or valve-related endocarditis can complicate cardiovascular implantable electronic device (CIED) infection in patients with both CIED and prosthetic valves. The objective of this study was to determine the outcomes of transvenous lead extraction for CIED infection in patients with prosthetic valves. METHODS AND RESULTS: We retrospectively screened 794 transvenous lead extraction procedures, between September 1, 2001 and August 31, 2012, at Mayo Clinic to identify patients with prosthetic valves who underwent lead extraction for infection...
September 2016: Circulation. Arrhythmia and Electrophysiology
Masahiko Goya, Michio Nagashima, Ken-Ichi Hiroshima, Kentaro Hayashi, Yu Makihara, Masato Fukunaga, Yoshimori An, Masatsugu Ohe, So-Ichiro Yamazato, Ko-Ichiro Sonoda, Kennosuke Yamashita, Kouji Katayama, Tomoaki Ito, Harushi Niu, Kenji Ando, Hiroyoshi Yokoi, Masashi Iwabuchi
BACKGROUND: Lead extraction using laser sheaths is performed mainly for cardiac implantable electronic device (CIED) infections. However, there are few reports concerning the management of CIED infections in Japan. METHODS AND RESULTS: Lead extraction procedures were performed in 183 patients targeting 450 leads (atrial leads: 170, ventricular: 181, implantable cardioverter-defibrillators (ICDs): 79, and coronary sinus: 20). One hundred twenty patients (65.6%) presented with pocket infections without the presentation of an endovascular infection...
August 2016: Journal of Arrhythmia
Hiroshi Nakajima, Masami Taki
BACKGROUND: We conducted a survey of the infection burden associated with the implantation of cardiac implantable electronic devices (CIEDs) in Japan. METHODS: The institutes were selected using annual device implantation data provided by Medtronic Japan Co., Ltd. The data sampling period was from January 1 to December 31, 2013. Institutes were classified into Group P, at which only pacemakers were implanted, and Group A, at which other CIEDs were implanted. Group P was further classified into three sub-groups by implantation number...
August 2016: Journal of Arrhythmia
Yusuke Kondo, Marehiko Ueda, Yoshio Kobayashi, Joerg O Schwab
There has been a significant increase in the number of patients receiving cardiovascular implantable electronic devices (CIED) over the last two decades. CIED infection represents a serious complication after CIED implantation and is associated with significant morbidity and mortality. Recently, newly advanced technologies have offered attractive and suitable therapeutic alternatives. Notably, the leadless pacemaker and anti-bacterial envelope decrease the potential risk of CIED infection and the resulting mortality, when it does occur...
August 2016: Journal of Arrhythmia
Yukio Sekiguchi
Along with the increased frequency of implantation, the incidence of cardiac implantable electronic device (CIED) infection, which can have serious or fatal complications, has also increased. Although several successful conservative therapies for CIED infection have been reported, retained infected devices remain a source of relapse, which is closely related to a higher mortality rate. Presently, complete hardware removal is initially recommended for infected CIED patients, and indications for conservative therapy, including continuous administration of antibiotics, require careful consideration...
August 2016: Journal of Arrhythmia
Katsuhiko Imai
Cardiac implantable electronic devices (CIEDs) have become important in the treatment of cardiac disease and placement rates increased significantly in the last decade. However, despite the use of appropriate antimicrobial prophylaxis, CIED infection rates are increasing disproportionately to the implantation rate. CIED infection often requires explantation of all hardware, and at times results in death. Surgical site infection (SSI) is the most common cause of CIED infection as a pocket infection. The best method of combating CIED infection is prevention...
August 2016: Journal of Arrhythmia
Daniel C DeSimone, M Rizwan Sohail
Cardiovascular implantable electronic devices (CIEDs) have become a critical component in management of patients with cardiac rhythm disturbances, heart failure, and prevention of sudden cardiac death. However, infection remains a major complication of CIED implantation and is associated with significant morbidity and mortality for device recipients. Early-onset CIED infections frequently originate from the generator pocket, secondary to device or pocket contamination at the time of implantation, and may progress to involve device leads or cardiac valves...
August 19, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Abdallah Fayssoil, Arnaud Lazarus, Karim Wahbi, Adam Ogna, Olivier Nardi, Frederic Lofaso, Bernard Clair, David Orlikowski, Djillali Annane
BACKGROUND/OBJECTIVES: Muscular dystrophies are genetic muscle disorders, in which heart involvement and chronic respiratory impairment affect survival. Cardiac conduction disturbances require implantable cardiac pacemaker. Implantable defibrillators may also be necessary to prevent cardiac sudden death. The safety and risk of cardiac electronic devices' implantation are not known in patients with muscular dystrophy. We aimed to assess the risks related to cardiac implantable electronic devices (CIED) in muscular dystrophy patients ventilated by tracheostomy...
November 1, 2016: International Journal of Cardiology
M Rizwan Sohail, Elizabeth L Eby, Michael P Ryan, Candace Gunnarsson, Laura A Wright, Arnold J Greenspon
BACKGROUND: Because of the increasing use of cardiac implantable electronic devices (CIEDs), it is important to estimate the incidence and annual healthcare expenditures associated with CIED infections. METHODS AND RESULTS: Patients with a record of an initial or replacement (full implant or generator only) CIED implant during the calendar years 2009 to 2012 in MarketScan Commercial Claims and Medicare Supplemental database were identified. CIED infections were classified into 4 categories: (1) infection not managed by inpatient admission nor implant removal, (2) infection managed by inpatient admission but no implant removal, (3) infection managed by an implant removal either in an inpatient or in an outpatient setting, and (4) infection with severe sepsis and managed in an inpatient setting with implant removal...
August 2016: Circulation. Arrhythmia and Electrophysiology
A Kornberger, B Luchting, F Kur, M Weis, F Weis, U A Stock, A Beiras-Fernandez
BACKGROUND: Infection is a main cause of morbidity and mortality after heart surgery, with multi-resistant pathogens increasingly representing a challenge. Daptomycin provides bactericidal activity against gram-positive organisms that are resistant to standard treatment including vancomycin. METHODS: A cohort of cardiac surgical patients, treated with daptomycin for major infection at two tertiary care centers, were retrospectively studied with a particular focus on the type of infection, causative pathogens and co-infections, daptomycin dosage, adverse events and outcome in order to provide evidence for the efficiency and safety of daptomycin in a distinct high-risk patient population...
2016: Journal of Cardiothoracic Surgery
Umashankar Lakshmanadoss, Bonita Nuanez, Ilana Kutinsky, Rizwan Khalid, David E Haines, Wai Shun Wong
BACKGROUND: Preprocedure systemic antibiotic prophylaxis reduces infections in patients undergoing cardiac implantable electronic devices (CIEDs) implantations. Whether pocket irrigation with antibiotic solution offers any advantage over saline solution in CIED implantation is unknown. METHODS: Records from 327 consecutive patients who underwent CIED implantation by three operators from February 2011 to January 2014 were reviewed. From February 2011 to January 2012, the antibiotic solution was used for pocket irrigation; from February 2012 to January 2014, saline solution was used...
September 2016: Pacing and Clinical Electrophysiology: PACE
Khaldoun G Tarakji, Christopher R Ellis, Pascal Defaye, Charles Kennergren
The incidence of infection following implantation of cardiac implantable electronic devices (CIEDs) is increasing at a faster rate than that of device implantation. Patients with a CIED infection usually require hospitalisation and complete device and lead removal. A significant proportion die from their infection. Transvenous lead extraction (TLE) is associated with rare but serious complications including major vascular injury or cardiac perforation. Operator experience and advances in lead extraction methods, including laser technology and rotational sheaths, have resulted in procedures having a low risk of complication and mortality...
May 2016: Arrhythmia & Electrophysiology Review
Mario Salmeri, Maria Grazia Sorbello, Silvana Mastrojeni, Angela Santanocita, Marina Milazzo, Giuseppe Di Stefano, Marina Scalia, Alessandro Addamo, Maria Antonietta Toscano, Stefania Stefani, Maria Lina Mezzatesta
The aim of the study was to describe the microbial aetiology of infections from cardiovascular implantable electronic devices (CIEDs) between 2001 and 2014 at The Centro Cuore Morgagni Hospital (Catania, Italy). In this 14-year retrospective study on pacemaker isolates 1,366 patients were evaluated and clinical data were collected. CIEDs were analyzed and isolates tested by routine microbiological techniques. The presence of bacterial biofilm was assessed by means of scanning electron microscopy. Of the patients, fifty-three had catheter-related infections (3...
June 1, 2016: Le Infezioni in Medicina
Westyn Branch-Elliman, Maggie Stanislawski, Judith Strymish, Anna E Barón, Kalpana Gupta, Paul D Varosy, Howard S Gold, P Michael Ho
BACKGROUND Infections following cardiovascular implantable electronic device (CIED) procedures, including pacemaker and implantable cardioverter-defibrillators, are devastating and costly. Preimplantation prophylactic antimicrobials are effective for reducing postprocedural infections. However, routine postprocedural antimicrobials are not associated with improved outcomes, and they may be harmful. Thus, we sought to characterize antimicrobial use patterns following CIED procedures. DESIGN All patients who underwent CIED procedures from October 1, 2007 to September 30, 2013 and had procedural information entered into the VA Clinical Assessment Reporting and Tracking (CART) software program were included in this study...
September 2016: Infection Control and Hospital Epidemiology
Abdulla Fakhro, Faryan Jalalabadi, Rodger H Brown, Shayan A Izaddoost
With their rising benefits, cardiac implantable electronic devices (CIEDs) such as pacemakers and left ventricular assist devices (LVADs) have witnessed a sharp rise in use over the past 50 years. As indications for use broaden, so too does their widespread employment with its attendant rise of CIED infections. Such large numbers of infections have inspired various algorithms mandating treatment. Early diagnosis of inciting organisms is crucial to tailoring appropriate antibiotic and or antifungal treatment...
May 2016: Seminars in Plastic Surgery
Steven Leung, Stephan Danik
Cardiac implantable electronic device (CIED) infections are complex medical problems that are increasingly encountered. They are associated with significant morbidity and mortality with tremendous economic cost. The current review will emphasize the prevention, diagnosis, and treatment of this clinical entity using the relatively limited evidence that is currently available. Because there is a paucity of high quality evidence regarding prevention, diagnosis, and treatment of CIED infections, this review will attempt to summarize the best evidence as well as to suggest, when possible, paradigms for care...
June 2016: Current Cardiology Reports
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