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[Pacemaker infection caused by Staphylococcus schleiferi]
Abstract:
Pacemaker infection is one of the severe complication of pacemaker implantation. We report a case of pacemaker infection caused by Staphylococcus schleiferi which is a coagulase-negative staphylococcus, and its relation with human infection is not well characterized. In 1994, a 80-year-old male presented with a pacemaker pocket infection, cutaneous inflammation but no fever 2 months after insertion of a pacemaker. S. schleiferi was isolated from the pus. The patient was given cefazolin for 5 days. One month later he was readmitted because of cutaneous inflammation and the extruded generator was removed. S. schleiferi was isolated from the generator. After the patient was treated with cefazolin for 3 weeks, four consecutive wound cultures were all negative. A new generator was inserted on the same side. One month after re-insertion, the patient again presented a cutaneous inflammation, and S. schleiferi was isolated from the pus as well as the generator and the leads on their removal. Twenty-six days later, a new pacing system was inserted on the other side. There was no further recurrence of the infection. Removal of the entire pacing system was necessary to cure the infection. We expect further information of human infections caused by S. schleiferi.
Insights
Pacemaker infections can be severe complications. This case highlights Staphylococcus schleiferi as a cause, demonstrating that complete removal of the pacing system is crucial for successful treatment.
Area of Science:
- Infectious Diseases
- Cardiology
- Medical Microbiology
Background:
- Pacemaker implantation is a common procedure, but device-related infections pose significant risks.
- Coagulase-negative staphylococci are known pathogens, yet Staphylococcus schleiferi's role in human infections remains less understood.
Observation:
- A case report details an 80-year-old male experiencing recurrent pacemaker pocket infections.
- Staphylococcus schleiferi was repeatedly isolated from pus, the pacemaker generator, and leads across multiple infections.
- Initial antibiotic treatment with cefazolin was insufficient, necessitating multiple interventions.
Findings:
- The patient underwent multiple device removals and replacements due to persistent Staphylococcus schleiferi infections.
- Complete explantation of the entire pacing system, followed by reimplantation on the contralateral side, ultimately resolved the infection.
- This case underscores the challenging nature of Staphylococcus schleiferi pacemaker infections.
Implications:
- Further research is needed to characterize the pathogenicity and treatment strategies for Staphylococcus schleiferi in medical device infections.
- Clinicians should consider Staphylococcus schleiferi in cases of refractory pacemaker infections.
- Complete device removal may be essential for eradicating persistent infections caused by this pathogen.