Implantable electrophysiologic cardiac device infections: a risk factor analysis

• Published in: European journal of clinical microbiology & infectious diseases Vol. 31; no. 11; pp. 3015 - 3021
• Main Authors: Raad, D., Irani, J., Akl, E. G., Choueiri, S., Azar, E., Abboud, J., Afif, C.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.11.2012; Springer; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Complications; Confidence intervals; Defibrillators, Implantable - microbiology; Demographics; Endocarditis; Factor analysis; Female; Hematoma; Historical account; Hospitals; Humans; Infection; Infections; Infectious diseases; Internal Medicine; Lead; Male; Medical Microbiology; Medical sciences; Medicine; Pacemaker, Artificial - microbiology; Patients; Prevalence; Prosthesis-Related Infections - epidemiology; Retrospective Studies; Reviews; Risk assessment; Risk Factors; Sepsis; Lebanon; United States > US; Beirut Lebanon; Cardiac Device; Pocket Infection; Permanent Pacemaker; Cardiac Catheterization Laboratory; Device Replacement; Heart; Infection; Microbiology; Risk analysis; Device; Risk factor
• ISSN: 0934-9723; 1435-4373; 1435-4373
• DOI: 10.1007/s10096-012-1655-1

The risk of cardiac device infection (CDI) is rising significantly, with several risk factors identified. The purpose of this study is to determine the rate of CDI at our center and to assess the associated risk factors, in order to define appropriate measures to prevent this complication. We retrospectively reviewed all cases of patients with CDI at St. George Hospital between February 1999 and July 2010. Each case was matched with three controls. We performed a descriptive and bivariate analysis to identify significant risk factors. Eighteen case patients and 54 control subjects met the inclusion criteria. An organism was recovered in 58 % of the cases. Significant risk factors included previous history of CDI ( p  < 0.001), recent manipulation ( p  < 0.001), trauma to the site of implant ( p  = 0.003), having a dual chamber/dual lead pacemaker ( p  = 0.002), and development of post-procedural hematoma ( p  = 0.012). Our findings complement the results of previous studies. We recommend a pre-procedural risk assessment and a thorough post-implantation follow-up to prevent the development of infective complications.