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Int. Rev. Allergol. Clin. Immunol. Family Med., 2014, XX/3: 117-124 Maximize

Int. Rev. Allergol. Clin. Immunol. Family Med., 2014, XX/3: 117-124

Title: Risk factors for cardiac device-related endocarditis in patients with permanent pacemakers and cardioverter-defibrillators

Authors: Skrzek A., Wysokiński A., Kozioł-Montewka M., Montewka M.

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02-03-2014

40,00 zł

SUMMARY IN POLISH & ENGLISH. FULL ARTICLE ONLY IN POLISH.

Risk factors for cardiac device-related endocarditis in patients with permanent pacemakers and cardioverter-defibrillators

Skrzek A.1, Wysokiński A.1, Kozioł-Montewka M.2, Montewka M.3

Medical University of Lublin, Poland: 1Chair and Department of Cardiology; 2Chair and Department of Medical Microbiology; 3Chair and Department of Obstetrics and Pathology of Pregnancy

Int. Rev. Allergol. Clin. Immunol. Family Med., 2014; Vol. 20, No. 3, 117

Cardiac device-related endocarditis (CDRE) is one of the most dangerous infectious complications in patients after implantation of permanent pacemakers (PMs) and implantable cardioverterdefibrillators (ICDs). CDRE represents 6.4–23% of all infectious complications in patients with PM/ICD.
The aim
was to determine CDRE risk factors, types and sources of various pathogens colonizing electrodes in patients with PMs/ ICDs.
Material and methods
. A retrospective analysis of the medical records of 107 patients was performed. These patients were admitted to Cardiology Clinic for transvenous removal of PMs/ ICDs. The indications to perform surgery were mechanical deterioration of PMs/ICDs, abnormal function and infectious complications.
Results
. In the analyzed group of patients the infection’s complications were found in 36 patients (34%) of which CDRE at 23 (64%). In patients with CDRE were 12 patients with local infection (33%) and 6 patients with symptoms of sepsis (26%). One of the patients died from multi-organ failure due to sepsis. In addition, diabetes was found in 22% of cases, chronic kidney disease (CKD) in 57%, severe chronic heart failure in 30%, thyroid diseases in 30%, obesity in 26% of cases. 57% of patients with CDRE were implanted dual-chamber system, single-chamber – 26% and triple-chamber – 18%. The most common bacteria found to be colonizing the removed electrodes were S. epidermidis (35%) and S. aureus (9%). Others like S. simulans, S. capitis, S. cohnii, S. warneri colonized leads in individual cases and have accounted for 17%. In the remaining patients, the cultures were negative due to the early empirical antibiotic therapy.
Conclusions
. CDRE risk factors in the analyzed group were: age, obesity, diabetes, thyroid diseases, CKD, severe CHF. CDRE frequently was observed in patients with multielectrode system. The most common bacteria that were colonizing the removed electrodes were S. epidermidis and S. aureus.

Key words: cardioverter – defibrillator, endocarditis, infection, permanent pacemaker, staphylococcus epidermidis