title: Patient Report and Review of Rapidly Growing Mycobacterial Infection after Cardiac Device Implantation.
abstract: Mycobacterial infections resulting from cardiac implantable electronic devices are rare, but as more devices are implanted, these organisms are increasingly emerging as causes of early-onset infections. We report a patient with an implantable cardioverter-defibrillator pocket and associated bloodstream infection caused by an organism of the Mycobacterium fortuitum group, and we review the literature regarding mycobacterial infections resulting from cardiac device implantations. Thirty-two such infections have been previously described; most (70%) were caused by rapidly growing species, of which M. fortuitum group species were predominant.When managing such infections, clinicians should consider the potential need for extended incubation of routine cultures or dedicated mycobacterial cultures for accurate diagnosis; combination antimicrobial drug therapy, even for isolates that appear to be macrolide susceptible, because of the potential for inducible resistance to this drug class; and the arrhythmogenicity of the antimicrobial drugs traditionally recommended for infections caused by these organisms.
authors.forename: Varun K
authors.initials: VK
authors.lastname: Phadke
authors.forename: David S
authors.initials: DS
authors.lastname: Hirsh
authors.forename: Neela D
authors.initials: ND
authors.lastname: Goswami
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D013504:Cardiovascular Surgical Procedures / Q000009:adverse effects; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000188:drug therapy / Q000209:etiology*; D019907:Mycobacterium fortuitum; D019736:Prostheses and Implants / Q000009:adverse effects
chemical_list: D000900:Anti-Bacterial Agents
keywords: Implantable cardioverter-defibrillator; Mycobacterium fortuitum group; bacteria; bloodstream infections; cardiac pacemaker; nontuberculous mycobacteria; rapidly growing mycobacteria; tuberculosis and other mycobacteria