CAMUS C, DUMONT E, LAVOUE S, ARVIEUX C, MICHELET C, DAUBERT J, THOMAS R; Interscience Conference on Antimicrobial Agents and Chemotherapy (42nd : 2002 : San Diego, Calif.).
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2002 Sep 27-30; 42: abstract no. K-589.
Service des Maladies Infectieuses et Reanimation Medicale, Rennes, France.
BACKGROUND: BSIs are a devastating complication of PM implantation. The incidence of confirmed cardiac device infection (CDI) in PM pts with S aureus bacteremia is as high as 45% (Chamis, Circulation, 2001). We evaluated the rate of confirmed CDI and prognosis of BSIs in PM pts. METHODS: From Jan. 1992 to Dec. 2000 at our Institution, we reviewed all pts who had an endocardial PM or defibrillator, >/= 2 positive blood cultures (bc) yielding the same microorganism or 1 bc positive for a usual pathogen in a pt with clinical evidence of infection. Confirmation of CDI was based on the existence of clinical infection or positive culture of any part of the device, or of vegetations. Death at hospital or 80 yr, no explantation, the absence of TEE and CDI not confirmed were associated with a higher mortality rate. Logistic regression identified the absence of TEE as the single independent risk factor for death (OR 7.5, 95%CI 1.5-37.3, P=.01). Overall, 56 pts had confirmed CDI (63%); this rate was higher for BSIs due to SE/CNS than for other organisms (78% vs 52%, P=.02). The 56 pts were explanted and 5 died (9%), due to infection in 2. Conclusion: This study emphasizes the need for TEE for optimal management of BSI in PM pts. Prompt explantation of confirmed CDI has a low mortality rate.
Publication Types:
Keywords:
- Bacteremia
- Candidiasis
- Echocardiography, Transesophageal
- Heart Diseases
- Humans
- Incidence
- Pacemaker, Artificial
- Risk Factors
- blood supply
- methods
- ultrasonography
Other ID:
UI: 102268269
From Meeting Abstracts