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Staphylococcus aureus bacteremia in patients with permanent pacemakers or implantable cardioverter-defibrillators

A L Chamis1, G E Peterson, C H Cabell

  • 1Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.

Circulation
|August 29, 2001
PubMed

Insights

Cardiac device infections (CDIs) are common in patients with Staphylococcus aureus bacteremia (SAB), affecting 45.4% overall. Early SAB shows higher infection rates, often with clinical signs, while late SAB has lower rates but still significant device involvement.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Device Technology

Background:

  • Cardiac device infections (CDIs) are serious complications.
  • The incidence of CDI in patients with bacteremia is not well-defined.
  • This study focuses on Staphylococcus aureus bacteremia (SAB) in patients with cardiac devices.

Purpose of the Study:

  • To determine the incidence of CDI in patients with pacemakers or implantable cardioverter-defibrillators who develop SAB.
  • To analyze the relationship between the timing of SAB and CDI development.
  • To assess the clinical presentation of CDI in these patients.

Main Methods:

  • Prospective cohort study of adult patients with SAB and cardiac devices over 6 years.
  • Evaluation of confirmed and possible CDI cases.
  • Analysis of early (<1 year) versus late (>=1 year) SAB.

Main Results:

  • Overall confirmed CDI incidence was 45.4% (15/33).
  • Early SAB (<1 year) had a 75% CDI rate (9/12).
  • Late SAB (>=1 year) had a 28.5% confirmed CDI rate (6/21) and 43% possible CDI rate (9/21).
  • 60% of confirmed CDI cases showed no local signs of infection.

Conclusions:

  • The incidence of CDI in patients with SAB and cardiac devices is high.
  • Physical exam and echocardiography cannot rule out CDI.
  • Early SAB often involves the device with clinical signs; late SAB has less obvious local signs but still significant device involvement (>28%).
Abstract

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