Related Experiment Video
Updated: Mar 3, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Cardiac Implantable Electronic Device Infections in Saudi Arabia: Incidence, Timing, Causative Organisms, and
Saad Albogami1, Wael Alqarawi2, Ahmed Alfagih3
1King Saud Medical City, Riyadh, Saudi Arabia.
Insights
Cardiac implantable electronic device infections occur in 2.8% of patients, especially after revisions. Prompt device removal is crucial for reducing mortality in these serious cardiac device infections.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Devices
Background:
- Cardiac implantable electronic devices (CIEDs) improve cardiac patient outcomes.
- Device-related infections pose a significant risk, negating CIED benefits.
- Epidemiological data on CIED infections in Saudi Arabia is limited.
Purpose of the Study:
- To investigate the epidemiology of CIED infections in Saudi Arabia.
- To identify risk factors and common pathogens associated with CIED infections.
- To evaluate the outcomes of different management strategies for CIED infections.
Main Methods:
- Multicenter retrospective cohort study of 4080 CIED recipients (pacemakers, ICDs, CRT) from 2017-2021.
- Follow-up for at least one year post-implantation.
- Data collection included demographics, device type, infection details, management, and outcomes.
Main Results:
- CIED infection incidence was 2.8% (98.8 per 10,000 person-years).
- Cardiac resynchronization therapy pacemakers (CRT-P) had the highest infection rate (7.7%). Revision procedures significantly increased infection risk (10.0%).
- Staphylococcus aureus was the most common pathogen. Mortality was higher in systemic infections (32.3%) and without device extraction (48.4%).
Conclusions:
- CIED infections are a significant concern in Saudi Arabia, affecting 2.8% of patients.
- Revision procedures and CRT-P recipients are at higher risk.
- Culture-negative infections and non-extraction management are associated with increased mortality, emphasizing the need for strict prevention and prompt intervention.
Background:
Cardiac implantable electronic devices (CIEDs) substantially improve outcomes in cardiac patients, but device-related infection can negate these benefits. Data on the epidemiology of CIED infections in Saudi Arabia are limited.
Methods:
We performed a multicenter retrospective cohort study of consecutive patients receiving CIEDs (pacemakers [PPM], implantable cardioverter-defibrillators [ICD], and cardiac resynchronization devices [CRT]) at three tertiary hospitals in Riyadh, Saudi Arabia, from January 2017 through December 2021. Patients were followed for at least one year post-implantation. Data collected included patient demographics, device type (new implant, replacement, revision), infection timing and microbiology, management (device extraction vs conservative treatment), and outcomes.
Results:
Of 4080 CIED recipients, 114 (2.8 %) developed device infections (incidence 98.8 per 10,000 person-years). CRT-P (cardiac resynchronization therapy pacemaker) devices had the highest infection rate (7.7 %). Revision procedures carried higher infection rates than initial implants or generator replacements (10.0 % vs 2.1 % vs 2.7 %; P < 0.001). The most common pathogens were Staphylococcus aureus (30.1 %), coagulase-negative staphylococci (10.6 %), and Pseudomonas aeruginosa (8.8 %); 38.9 % of infections were culture-negative. Systemic infections and patients managed without device removal had significantly higher mortality (32.3 % vs 8.2 % for systemic vs pocket; 48.4 % vs 12.0 % for no extraction vs extraction; P < 0.001 for both).
Conclusions:
In this large Saudi cohort, CIED infection occurred in 2.8 % of patients, particularly following revision procedures and in CRT-P recipients. Infections were often culture-negative and associated with substantial mortality, especially in systemic cases or when devices were not removed. These findings highlight the importance of strict infection-prevention protocols, early recognition, and prompt complete device extraction to improve patient outcomes.
Related Concept Videos
01:25Endocarditis I: Introduction
01:18Endocarditis III: Medical Management
01:25Endocarditis II: Clinical Features of Infective Endocarditis
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...