Application of an Infection Control Protocol (ICP) Reduced Cardiac Device Infection (CDI) in Low-Volume Centers

Area of Science:

• Cardiology
• Infectious Diseases
• Healthcare Management

Background:

• Cardiac device infection (CDI) is a significant complication following cardiovascular implantable electronic device (CIED) procedures.
• While several risk factors for CDI are known, others remain uncertain, necessitating further investigation.
• Low-volume centers present a particular challenge in managing CDI rates.

Purpose of the Study:

• To identify and evaluate risk factors associated with cardiac device infections (CDIs).
• To assess the efficacy of an infection control protocol (ICP) in reducing CDI rates, particularly in low-volume settings.
• To analyze the impact of center volume on CDI incidence.

Main Methods:

• A retrospective study involving 1259 patients undergoing permanent pacemaker (PPM) implantation over three years.
• Analysis of risk factors including male gender, diabetes, chronic kidney disease (CKD), operation duration, and PPM replacement.
• Comparison of CDI rates, medical costs, and microbiology data between high-volume and low-volume centers, with ICP implementation in the latter.

Main Results:

• Male gender, diabetes, CKD, prolonged operation duration, PPM replacement, and low center volume were identified as significant risk factors for CDIs.
• CDI rates were substantially higher in low-volume centers compared to high-volume centers.
• Implementing an ICP in low-volume centers led to a dramatic reduction in CDI rates without significant cost increases.

Conclusions:

• Infection control protocols (ICPs) are practical, effective, and economical for managing CDIs in low-volume centers.
• Low center volume is a modifiable risk factor for CDI that can be addressed through standardized protocols.
• ICP implementation is a key strategy for improving patient safety in CIED procedures, especially in resource-limited settings.