title: Bacterial Contamination During Pacemaker Implantation Is Common and Does Not Always Result in Infection.
abstract: BACKGROUND
  Bacterial cultures of cardiovascular implantable electronic devices removed from patients without clinical infection are often positive, and the cultured bacteria are different from those at the time of clinical infection. This discrepancy has not been adequately explained. We hypothesized that the cause is bacterial contamination at operation and compared the results of bacterial cultures between patients with de novo pacemaker implantation and those with pacemaker replacement.
  
  
  RESULTS
  We prospectively enrolled consecutive 100 patients who underwent cardiac pacemaker implantation (49 de novo implantations, 51 replacements). We took swab cultures from inside the generator pocket (1) immediately after the creation of new pocket or removal of old generator, (2) after connection of leads to new generator, and (3) after pocket lavage. Swab cultures were positive in 272 (45%) of 600 samples. The majority of the cultured bacteria were Propionibacterium species. No statistical difference was detected between de novo implantations and replacements in the positive ratio of swab cultures. The positive ratio was not correlated with the number of previous device replacements.
  
  
  CONCLUSIONS
  The positive ratio of swab cultures was not different between new implantations and replacements, suggesting that a positive culture merely indicates contamination of bacteria during operation rather than colonization.
authors.affiliation: Cardiovascular Division, Osaka Police Hospital.
authors.forename: Masato
authors.initials: M
authors.lastname: Okada
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kashiwase
authors.forename: Akio
authors.initials: A
authors.lastname: Hirata
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Nemoto
authors.forename: Koshi
authors.initials: K
authors.lastname: Matsuo
authors.forename: Ayaka
authors.initials: A
authors.lastname: Murakami
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Ueda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017147:Defibrillators, Implantable / Q000382:microbiology*; D004866:Equipment Contamination; D005260:Female; D016908:Gram-Positive Bacterial Infections; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000382:microbiology*; D011424:Propionibacterium / Q000254:growth & development / Q000302:isolation & purification; D011446:Prospective Studies