title: Genetic identification and risk factor analysis of asymptomatic bacterial colonization on cardiovascular implantable electronic devices.
abstract: Asymptomatic bacterial colonization of cardiovascular implantable electronic devices (CIEDs) is widespread and increases the risk of clinical CIED infection. The aim of the study was to evaluate the incidence of bacterial colonization of generator pockets in patients without signs of infection and to analyze the relationship with clinical infection and risk factors. From June 2011 to December 2012, 78 patients underwent CIED replacement or upgrade. Exclusion criteria included a clinical diagnosis of CIED infection, bacteremia, or infective endocarditis. All patients were examined for evidence of bacterial 16S rDNA on the device and in the surrounding tissues. Infection cases were recorded during follow-up. The bacterial-positive rate was 38.5% (30 cases); the coagulase-negative Staphylococcus detection rate was the highest (9 cases, 11.5%). Positive bacterial DNA results were obtained from pocket tissue in 23.1% of patients (18 cases), and bacterial DNA was detected on the device in 29.5% of patients (23 cases). During follow-up (median 24.6 months), two patients (6.7%, 2/30) became symptomatic with the same species of microorganism, S. aureus and S. epidermidis. Multivariable logistic regression analysis found that the history of bacterial infection, use of antibiotics, application of antiplatelet drugs, replacement frequency, and renal insufficiency were independent risk factors for asymptomatic bacterial colonization.
authors.affiliation: Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao 266100, China.
authors.forename: Xian-Ming
authors.initials: XM
authors.lastname: Chu
authors.affiliation: Department of Biology, Medical College of Qingdao University, Qingdao 266021, China.
authors.forename: Bing
authors.identifier: 0000-0002-8243-8705
authors.initials: B
authors.lastname: Li
authors.affiliation: Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao 266100, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: An
authors.affiliation: Department of Cardiac Electrophysiology, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Xue-Bin
authors.initials: XB
authors.lastname: Li
authors.affiliation: Department of Cardiac Electrophysiology, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Ji-Hong
authors.initials: JH
authors.lastname: Guo
mesh_terms: D000368:Aged; D018441:Biofilms; D004696:Endocarditis / Q000382:microbiology / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000382:microbiology*; D019736:Prostheses and Implants / Q000009:adverse effects / Q000382:microbiology*; D016459:Prosthesis-Related Infections / Q000235:genetics / Q000382:microbiology*; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000235:genetics* / Q000473:pathology; D013211:Staphylococcus aureus / Q000235:genetics* / Q000302:isolation & purification
chemical_list: D012336:RNA, Ribosomal, 16S