Clinical Microbiology: Open Access

Abstract

Etiology, Clinical Manifestations and Microbiological Profile of Cardiac Device Infections

Aneta Skrzek-Montewka, Andrzej Wysokinski and Maciej Montewka

Introduction: Cardiovascular implantable electronic device infections (CIEDIs) cause a lot of serious clinical problems among which lead dependent infective endocarditis (LDIE) is considered to be the worst. Background: The background of the study was to analyze the parameters of clinical manifestations, determine the etiology and microbiological profile of the infections as well as evaluate the role of echocardiography in diagnosing LDIE. Methods: Retrospective examinations were carried out in Reference Clinical Cardiology Centre in Lublin, Poland. The study group comprised 767 patients who between 2009 and 2014 underwent transvenous lead extraction (TLE) for infective and non-infective reasons. Results: The study group comprised 382 patients with infective complications and 385 without infection. CIEDI group included 30.1% LDIE patients, 38.48% pocket infection patients (PI) and 31.41% mixed LDIE and PI patients. Fever was most frequently reported in LDIE patients. Significantly more LDIE patients were found to suffer from concomitant infections. LDIE group comprised significantly more patients with hs-CRP>50 mg/dL. Analysis of microbiological data showed that the most common cause of the infective complications were Staphylococcus epidermis and Staphylococcus aureus. Echocardiography examination revealed the presence of vegetation in 78.26% of LDIE patients in TEE and in 63.48% in TTE. Conclusions: Fever and concomitant infections predominated in the clinical picture of LDIE. Hs-CRP value proved to be essential for diagnostic procedures. TEE examination proved to be more effective in revealing vegetation than TTE. The most common cause of infective complications was S. epidermidis and S. aureus which points out to the endogenic source of infections.