Detailed bacteriologic tests to identify the origin of transvenous pacing system infections indicate a high prevalence of multiple organisms - 21/08/11
, Frédéric Wallet, MD b, Salem Kacet, MD a, René J. Courcol, MD, PhD b
Reprint requests: Didier Klug, MD, Department of Cardiology A, Hôpital Cardiologique de Lille, CHRU, 59037 Lille, France.Résumé |
Background |
The reported incidence of pacing system–related infections (PSIs) varies widely, and the roles of leads and blood cultures remain poorly defined.
Methods |
Leads and blood cultures were obtained prospectively in 224 patients with suspected PSIs, and the results of cultures of blood and extravascular and intravascular lead fragments were compared.
Results |
In 12.3% of the patients, no microorganism was found on the leads. Lead cultures with ≥1 microorganism cultured on the extravascular and intravascular fragments of the leads were found in 88.5% of the positive lead cultures. Infection was caused by Staphylococcus epidermidis and coagulase-negative staphylococci in 66.0% and 29.5%, respectively. Only 33 patients had positive blood cultures according to the Duke criteria with the same microorganism found by lead cultures in 30 cases. Infection was caused by multiple organisms in 39 (25%) patients.
Conclusion |
(1) Regardless of the clinical presentation, the extravascular and intravascular body of the lead is infected, even when the infection is local. More than one microorganism may be implicated. (2) Bacteriologic analyses must be performed on several segments of each implanted lead. (3) More than 2 positive blood cultures are a reliable clinical criterion for the diagnosis of pacemaker lead–related infection, but blood cultures alone are an insensitive method to identify the cause of infection. (4) Up to 50% of microorganisms isolated in a single blood culture are also recovered in lead cultures.
Le texte complet de cet article est disponible en PDF.Plan
Vol 149 - N° 2
P. 322-328 - février 2005 Retour au numéro
Article précédent
- Comparative efficacy of monophasic and biphasic waveforms for transthoracic cardioversion of atrial fibrillation and atrial flutter
- Osnat T. Gurevitz, Naser M. Ammash, Joseph F. Malouf, Krishnaswamy Chandrasekaran, Ana Gabriela Rosales, Karla V. Ballman, Stephen C. Hammill, Roger D. White, Bernard J. Gersh, Paul A. Friedman
- Fluvastatin reduces the impact of diabetes on long-term outcome after coronary intervention—A Lescol Intervention Prevention Study (LIPS) substudy
- Chourmouzios A. Arampatzis, Dick Goedhart, Patrick W. Serruys, Francesco Saia, Pedro A. Lemos, Pim de Feyter, on behalf of the LIPS Investigators
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?