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Cardiovascular implantable electronic device infections: associated risk factors and prevention.
Journal article

Cardiovascular implantable electronic device infections: associated risk factors and prevention.

  • Rohacek M Department of Emergency Medicine, Basel University Hospital, Switzerland.
  • Baddour LM Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
  • 2015-08-01
Published in:
  • Swiss medical weekly. - 2015
Age Factors
Antibiotic Prophylaxis
Cardiovascular Diseases
Comorbidity
Defibrillators, Implantable
Humans
Infection Control
Pacemaker, Artificial
Postoperative Complications
Retrospective Studies
Risk Factors
Sex Factors
Staphylococcal Infections
Staphylococcus aureus
English Infections of cardiovascular implantable electric devices (CIED) are a burden on patients and healthcare systems and should be prevented. The most frequent pathogens are coagulase-negative staphylococci and Staphylococcus aureus. The most important risk factors for CIED infections are diabetes mellitus, renal and heart failure, corticosteroid use, oral anticoagulation, fever within 24 hours before the procedure and leucocytosis, implantable cardioverter defibrillator compared with pacemaker, especially in the case of Staphylococcus aureus bacteraemia, lack of antibiotic prophylaxis, and postoperative haematoma and other wound complications. Other important risk factors are history of prior procedures and previous CIED infections, number of leads, use of povidone-iodine compared with chlorhexidine-alcohol, and centres and operators with a low volume of implants. To prevent CIED infections, patients undergoing CIED procedures and appropriate devices should be carefully selected, and interventions should be performed by trained operators. Antibiotic prophylaxis should be administered, and skin antisepsis should be done with chlorhexidine-alcohol. Oral anticoagulation should be continued during CIED procedures in high-risk patients for thromboembolism, instead of bridging with heparin. Early reintervention in cases of haematoma or lead dislodgement should be avoided. The implementation of infection prevention programmes reduces infection rates. More randomised controlled studies are needed to evaluate prevention strategies, especially skin preparation and antibiotic prophylaxis with glycopeptides.
Language
  • English
Open access status
gold
Identifiers
Persistent URL
https://sonar.ch/global/documents/232247
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