Analysis of extracted cardiac device leads for bacteria type: clinical impact.
The use of cardiac implantable electronic devices (CIED) increased over time, followed by rise of CIED-related complications, mainly infections and malfunctions. A clear diagnosis of CIED infection is of pivotal importance. When infection is confirmed, transvenous lead extraction (TLE) becomes mandatory, with associated risks and mortality. Local lesions at the device pocket often return negative swabs and tissue specimens, but conservative interventions are inconclusive, raising risks of systemic dissemination of infection and difficulties of subsequent TLE any more. When local bacteriological analyses are positive, once again, a contamination effect cannot be excluded. So traditional local swabs and tissue specimens exhibit low sensitivity and specificity for diagnosis of CIED infection. On the contrary, in cases sepsis, blood samples show high specificity, while the sensibility remains low, due to possible negative results in patients on antibiotics. In this scenario, the analysis of extracted device leads seems more appropriate for diagnostic purposes.
Department of Internal Medicine, Division of Cardiology, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Turin, Corso A. M. Dogliotti, 14, 10126 Torino, Italy.
Pier Giorgio
PG
Golzio
Fabrizio
F
D'Ascenzo
Jacopo
J
Perversi
Fiorenzo
F
Gaita
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D020878:Device Removal / Q000379:methods; D006801:Humans; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology
D000900:Anti-Bacterial Agents