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Current Cardiology Reports
Erschienen in: Current Cardiology Reports 8/2023

23.06.2023 | Invasive Electrophysiology and Pacing (EK Heist, Section Editor)

Risk of Cardiac Implantable Electronic Device Infection in Patients with Bloodstream Infection: Microbiologic Effect in the Era of Positron Emission Tomography–Computed Tomography

verfasst von: Supavit Chesdachai, Daniel C. DeSimone, Larry M. Baddour

Erschienen in: Current Cardiology Reports | Ausgabe 8/2023

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Abstract

Purpose of Review

Bloodstream infection (BSI) in patients with cardiac implantable electronic devices (CIEDs) is common and can prompt challenges in defining optimal management. We provide a contemporary narrative review of this topic and propose a pathogen-dependent clinical approach to patient management.

Recent Findings

BSI due to staphylococci, viridans group streptococci, and enterococci is associated with an increased risk of underlying CIED infection, while the risk of CIED infection due to other organisms is poorly defined. There is growing evidence that positron emission tomography–computed tomography may be helpful in some patients with BSI and underlying CIED.

Summary

Twenty studies were included to examine the impact of microbiologic findings on the risk of CIED infection among patients with BSI. Diagnosis of CIED infection in patients with BSI without pocket findings is often difficult, necessitating the use of novel diagnostic tools to help guide the clinician in subsequent patient management.
Literatur
1.
Tracy CM, Epstein AE, Darbar D, DiMarco JP, Dunbar SB, Estes NAM, et al. 2012 ACCF/AHA/HRS focused update of the 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Heart Rhythm. 2012;9(10):1737–53.CrossRefPubMed
2.
Shah MJ, Silka MJ, Silva JNA, Balaji S, Beach CM, Benjamin MN, et al. 2021 PACES expert consensus statement on the indications and management of cardiovascular implantable electronic devices in pediatric patients: developed in collaboration with and endorsed by the Heart Rhythm Society (HRS), the American College of Cardiology (ACC), the American Heart Association (AHA), and the Association for European Paediatric and Congenital Cardiology (AEPC) endorsed by the Asia Pacific Heart Rhythm Society (APHRS), the Indian Heart Rhythm Society (IHRS), and the Latin American Heart Rhythm Society (LAHRS). JACC Clin Electrophysiol. 2021;7(11):1437–72.
3.
Mond HG, Proclemer A. The 11th world survey of cardiac pacing and implantable cardioverter-defibrillators: calendar year 2009–a World Society of Arrhythmia’s project. Pacing Clin Electrophysiol. 2011;34(8):1013–27.CrossRefPubMed
4.
Khurshid R, Awais M, Malik J. Electrophysiology practice in low- and middle-income countries: an updated review on access to care and health delivery. Heart Rhythm O2. 2023;4(1):69–77.
5.
Raatikainen MJP, Arnar DO, Merkely B, Nielsen JC, Hindricks G, Heidbuchel H, et al. A decade of information on the use of cardiac implantable electronic devices and interventional electrophysiological procedures in the European Society of Cardiology countries: 2017 report from the European Heart Rhythm Association. EP Europace. 2017;19(suppl_2):ii1-ii90.
6.
Greenspon AJ, Patel JD, Lau E, Ochoa JA, Frisch DR, Ho RT, et al. 16-year trends in the infection burden for pacemakers and implantable cardioverter-defibrillators in the United States 1993 to 2008. J Am Coll Cardiol. 2011;58(10):1001–6.CrossRefPubMed
7.
Dai M, Cai C, Vaibhav V, Sohail MR, Hayes DL, Hodge DO, et al. Trends of cardiovascular implantable electronic device infection in 3 decades: a population-based study. JACC Clin Electrophysiol. 2019;5(9):1071–80.CrossRefPubMed
8.
Wilkoff BL, Boriani G, Mittal S, Poole JE, Kennergren C, Corey GR, et al. Impact of cardiac implantable electronic device infection: a clinical and economic analysis of the WRAP-IT trial. Circ Arrhythm Electrophysiol. 2020;13(5):e008280-e.
9.
Nagpal A, Baddour LM, Sohail MR. Microbiology and pathogenesis of cardiovascular implantable electronic device infections. Circ Arrhythm Electrophysiol. 2012;5(2):433–41.
10.
Palmeri Nicholas O, Kramer Daniel B, Karchmer Adolf W, Zimetbaum Peter J. A review of cardiac implantable electronic device infections for the practicing electrophysiologist. JACC: Clinical Electrophysiology. 2021;7(6):811–24.
11.
DeSimone DC, Sohail MR. Management of bacteremia in patients living with cardiovascular implantable electronic devices. Heart Rhythm. 2016;13(11):2247–52.CrossRefPubMed
12.
Minejima E, Mai N, Bui N, Mert M, Mack WJ, She RC, et al. Defining the breakpoint duration of Staphylococcus aureus bacteremia predictive of poor outcomes. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America. 2020;70(4):566–73.CrossRefPubMed
13.
Horino T, Hori S. Metastatic infection during Staphylococcus aureus bacteremia. J Infect Chemother. 2020;26(2):162–9.CrossRefPubMed
14.
Chamis AL, Peterson GE, Cabell CH, Corey GR, Sorrentino RA, Greenfield RA, et al. Staphylococcus aureus bacteremia in patients with permanent pacemakers or implantable cardioverter-defibrillators. Circulation. 2001;104(9):1029–33.CrossRefPubMed
15.
Uslan DZ, Dowsley TF, Sohail MR, Hayes DL, Friedman PA, Wilson WR, et al. Cardiovascular implantable electronic device infection in patients with Staphylococcus aureus bacteremia. Pacing Clin Electrophysiol. 2010;33(4):407–13.CrossRefPubMed
16.
Obeid KM, Szpunar S, Khatib R. Long-term outcomes of cardiovascular implantable electronic devices in patients with Staphylococcus aureus bacteremia. Pacing Clin Electrophysiol. 2012;35(8):961–5.CrossRefPubMed
17.
Maskarinec SA, Thaden JT, Cyr DD, Ruffin F, Souli M, Fowler VG. The risk of cardiac device-related infection in bacteremic patients is species specific: results of a 12-year prospective cohort. Open Forum Infect Dis. 2017;4(3):ofx132.
18.
Snygg-Martin U, Ruus C, Skovbjerg S, Studahl M, Andersson LM. Does extraction of cardiac implantable electronic devices improve outcome in patients with Staphylococcus aureus bacteraemia? Infect Dis (Lond). 2020;52(12):877–82.CrossRefPubMed
19.
Sohail MR, Palraj BR, Khalid S, Uslan DZ, Al-Saffar F, Friedman PA, et al. Predicting risk of endovascular device infection in patients with Staphylococcus aureus bacteremia (PREDICT-SAB). Circ Arrhythm Electrophysiol. 2015;8(1):137–44.CrossRefPubMed
20.
Chesdachai S, Baddour LM, Sohail MR, Palraj BR, Madhavan M, Tabaja H, et al. Evaluation of European Heart Rhythm Association consensus in patients with cardiovascular implantable electronic devices and Staphylococcus aureus bacteremia. Heart Rhythm. 2021.
21.
Nakajima I, Narui R, Tokutake K, Norton CA, Stevenson WG, Richardson TD, et al. Staphylococcus bacteremia without evidence of cardiac implantable electronic device infection. Heart Rhythm. 2021;18(5):752–9.CrossRefPubMed
22.
•• Blomström-Lundqvist C, Traykov V, Erba PA, Burri H, Nielsen JC, Bongiorni MG, et al. European Heart Rhythm Association (EHRA) international consensus document on how to prevent, diagnose, and treat cardiac implantable electronic device infections-endorsed by the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), the Latin American Heart Rhythm Society (LAHRS), International Society for Cardiovascular Infectious Diseases (ISCVID) and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Europace. 2020;22(4):515–49. The most recent International guidelines that are widely endorsed and address the prevention, diagnosis, and management of CIED infections.
23.
Berge A, Strand R, Nilson B, Naucler P, Rasmussen M. Staphylococcus aureus bacteremia, cardiac implantable electronic device, extraction, and the risk of recurrence. J Infect. 2022;84(5):e67–9.CrossRefPubMed
24.
Pichtchoulin S, Selmeryd I, Freyhult E, Hedberg P, Selmeryd J. Staphylococcus aureus bacteremia and cardiac implantable electronic devices in a county hospital setting: a population-based retrospective cohort study. Ups J Med Sci. 2021;126.
25.
Boix-Palop L, Dietl B, Calbo E, Di Marco A, Xercavins M, Pérez-Crespo PMM, et al. Risk of cardiac device-related infection in patients with late-onset bloodstream infection. Analysis on a National Cohort. J Infect. 2022;85(2):123–9.
26.
Berge A, Carlsén C, Petropoulos A, Gadler F, Rasmussen M. Staphylococcus aureus bacteraemia, cardiac implantable electronic device, and the risk of endocarditis: a retrospective population–based cohort study. Eur J Clin Microbiol Infect Dis. 2023.
27.
Madhavan M, Sohail MR, Friedman PA, Hayes DL, Steckelberg JM, Wilson WR, et al. Outcomes in patients with cardiovascular implantable electronic devices and bacteremia caused by Gram-positive cocci other than Staphylococcus aureus. Circ Arrhythm Electrophysiol. 2010;3(6):639–45.CrossRefPubMed
28.
Esquer Garrigos Z, George MP, Vijayvargiya P, Tan EM, Farid S, Abu Saleh OM, et al. Clinical presentation, management, and outcomes of cardiovascular implantable electronic device infections due to gram-negative versus gram-positive bacteria. Mayo Clin Proc. 2019;94(7):1268–77.CrossRefPubMed
29.
• Chesdachai S, Baddour LM, Sohail MR, Palraj BR, Madhavan M, Tabaja H, et al. Bacteremia due to non–Staphylococcus aureus gram-positive cocci and risk of cardiovascular implantable electronic device infection. Heart Rhythm 02. 2022. Few studies have focused on BSI due to non-SA GPC which are a frequent cause of BSI. This study demonstrated that the prevalence of CIED infection in non-SA GPC BSI was higher than previously reported, particularly in cases due to CoNS, Enterococcus species, and VGS.
30.
Chamat-Hedemand S, Dahl A, Østergaard L, Arpi M, Fosbøl E, Boel J, et al. Prevalence of infective endocarditis in streptococcal bloodstream infections is dependent on streptococcal species. Circulation. 2020;142(8):720–30.CrossRefPubMed
31.
Dahl A, Iversen K, Tonder N, Hoest N, Arpi M, Dalsgaard M, et al. Prevalence of infective endocarditis in Enterococcus faecalis bacteremia. J Am Coll Cardiol. 2019;74(2):193–201.CrossRefPubMed
32.
•• George MP, Esquer Garrigos Z, Vijayvargiya P, Anavekar NS, Luis SA, Wilson WR, et al. Discriminative ability and reliability of transesophageal echocardiography in characterizing cases of cardiac device lead vegetations versus noninfectious echodensities. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America. 2021;72(11):1938–43. Finding of this study showed that TEE cannot distinguish between bland clots on a lead, which are common, and infected vegetations. The result is there could be an “over” diagnosis of CIED infection with resultant CIED removal.
33.
Berge A, Arkel L, Nilson B, Rasmussen M. Enterococcus faecalis bacteremia, cardiac implantable electronic device, extraction, and the risk of recurrence. Infection. 2022;50(6):1517–23.CrossRefPubMedPubMedCentral
34.
Uslan DZ, Sohail MR, Friedman PA, Hayes DL, Wilson WR, Steckelberg JM, et al. Frequency of permanent pacemaker or implantable cardioverter-defibrillator infection in patients with gram-negative bacteremia. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2006;43(6):731–6.CrossRefPubMed
35.
Chesdachai S, Baddour LM, Sohail MR, Palraj BR, Madhavan M, Tabaja H, et al. Risk of cardiovascular implantable electronic device infection in patients presenting with gram-negative bacteremia. Open Forum Infect Dis. 2022.
36.
37.
Gajdács M, Urbán E. Relevance of anaerobic bacteremia in adult patients: a never-ending story? Eur J Microbiol Immunol (Bp). 2020;10(2):64–75.CrossRefPubMed
38.
Hussein AA, Baghdy Y, Wazni OM, Brunner MP, Kabbach G, Shao M, et al. Microbiology of cardiac implantable electronic device infections. JACC Clin Electrophysiol. 2016;2(4):498–505.
39.
Esquer Garrigos Z, George MP, Khalil S, Vijayvargiya P, Abu Saleh OM, Friedman PA, et al. Predictors of bloodstream infection in patients presenting with cardiovascular implantable electronic device pocket infection. Open Forum Infect Dis. 2019;6(4):ofz084.
40.
Comba IY, Chesdachai S, Tabaja H, Mahmood M, Deml S, Wengenack NL, et al. Cardiovascular device infections due to rapidly growing Mycobacteria: a review of cases at a tertiary care hospital. J Clin Tuberc Other Mycobact Dis. 2022;26: 100296.CrossRefPubMedPubMedCentral
41.
Nakamura T, Narui R, Holmes B, Norton C, Kim EJ, Nakajima I, et al. Candidemia in patients with cardiovascular implantable electronic devices. J Interv Card Electrophysiol. 2021;60(1):69–75.CrossRefPubMed
42.
Baman JR, Medhekar AN, Jain SK, Knight BP, Harrison LH, Smith B, et al. Management of systemic fungal infections in the presence of a cardiac implantable electronic device: a systematic review. Pacing Clin Electrophysiol. 2021;44(1):159–66.CrossRefPubMed
43.
Vilacosta I, Sarriá C, San Román JA, Jiménez J, Castillo JA, Iturralde E, et al. Usefulness of transesophageal echocardiography for diagnosis of infected transvenous permanent pacemakers. Circulation. 1994;89(6):2684–7.CrossRefPubMed
44.
Kusumoto FM, Schoenfeld MH, Wilkoff BL, Berul CI, Birgersdotter-Green UM, Carrillo R, et al. 2017 HRS expert consensus statement on cardiovascular implantable electronic device lead management and extraction. Heart Rhythm. 2017;14(12):e503–51.CrossRefPubMed
45.
Baddour LM, Epstein AE, Erickson CC, Knight BP, Levison ME, Lockhart PB, et al. Update on cardiovascular implantable electronic device infections and their management: a scientific statement from the American Heart Association. Circulation. 2010;121(3):458–77.CrossRefPubMed
46.
Patel NJ, Singleton MJ, Brunetti R, Richardson KM, Bhave PD. Evaluation of lead-based echodensities on transesophageal echocardiogram in patients with cardiac implantable electronic devices. J Cardiovasc Electrophysiol. 2023;34(1):7–13.CrossRefPubMed
47.
Sarrazin JF, Philippon F, Tessier M, Guimond J, Molin F, Champagne J, et al. Usefulness of fluorine-18 positron emission tomography/computed tomography for identification of cardiovascular implantable electronic device infections. J Am Coll Cardiol. 2012;59(18):1616–25.CrossRefPubMed
48.
Cautela J, Alessandrini S, Cammilleri S, Giorgi R, Richet H, Casalta JP, et al. Diagnostic yield of FDG positron-emission tomography/computed tomography in patients with CEID infection: a pilot study. Europace. 2013;15(2):252–7.CrossRefPubMed
49.
Graziosi M, Nanni C, Lorenzini M, Diemberger I, Bonfiglioli R, Pasquale F, et al. Role of 18F-FDG PET/CT in the diagnosis of infective endocarditis in patients with an implanted cardiac device: a prospective study. Eur J Nucl Med Mol Imaging. 2014;41(8):1617–23.CrossRefPubMed
50.
Tlili G, Amraoui S, Mesguich C, Rivière A, Bordachar P, Hindié E, et al. High performances of (18)F-fluorodeoxyglucose PET-CT in cardiac implantable device infections: a study of 40 patients. J Nucl Cardiol. 2015;22(4):787–98.CrossRefPubMed
51.
Diemberger I, Bonfiglioli R, Martignani C, Graziosi M, Biffi M, Lorenzetti S, et al. Contribution of PET imaging to mortality risk stratification in candidates to lead extraction for pacemaker or defibrillator infection: a prospective single center study. Eur J Nucl Med Mol Imaging. 2019;46(1):194–205.CrossRefPubMed
52.
Jerónimo A, Olmos C, Vilacosta I, Ortega-Candil A, Rodríguez-Rey C, Pérez-Castejón MJ, et al. Accuracy of (18)F-FDG PET/CT in patients with the suspicion of cardiac implantable electronic device infections. J Nucl Cardiol. 2022;29(2):594–608.CrossRefPubMed
53.
Mahmood M, Kendi AT, Farid S, Ajmal S, Johnson GB, Baddour LM, et al. Role of (18)F-FDG PET/CT in the diagnosis of cardiovascular implantable electronic device infections: A meta-analysis. J Nucl Cardiol. 2019;26(3):958–70.CrossRefPubMed
54.
Juneau D, Golfam M, Hazra S, Zuckier LS, Garas S, Redpath C, et al. Positron emission tomography and single-photon emission computed tomography imaging in the diagnosis of cardiac implantable electronic device infection: a systematic review and meta-analysis. Circ Cardiovasc Imaging. 2017;10(4).
55.
Wang TKM, Sánchez-Nadales A, Igbinomwanhia E, Cremer P, Griffin B, Xu B. Diagnosis of infective endocarditis by subtype using 18F-fluorodeoxyglucose positron emission tomography/computed tomography. Circ Cardiovasc Imaging. 2020;13(6):e010600.
Metadaten
Titel
Risk of Cardiac Implantable Electronic Device Infection in Patients with Bloodstream Infection: Microbiologic Effect in the Era of Positron Emission Tomography–Computed Tomography
verfasst von
Supavit Chesdachai
Daniel C. DeSimone
Larry M. Baddour
Publikationsdatum
23.06.2023
Verlag
Springer US
Erschienen in
Current Cardiology Reports / Ausgabe 8/2023
Print ISSN: 1523-3782
Elektronische ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-023-01900-y

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