title: Infections of cardiovascular implantable electronic devices: 14 years of experience in an Italian hospital.
abstract: The aim of the study was to describe the microbial aetiology of infections from cardiovascular implantable electronic devices (CIEDs) between 2001 and 2014 at The Centro Cuore Morgagni Hospital (Catania, Italy). In this 14-year retrospective study on pacemaker isolates 1,366 patients were evaluated and clinical data were collected. CIEDs were analyzed and isolates tested by routine microbiological techniques. The presence of bacterial biofilm was assessed by means of scanning electron microscopy. Of the patients, fifty-three had catheter-related infections (3.9%), mainly resulting from Staphylococci (4 S. aureus, 32 S. epidermidis, 15 S. hominis, 3 S. haemolyticus, 1 S. warnerii, 1 S. schleiferi, 1 S. lentus and 1 S. capitis) that covered the cardiac catheter with biofilm. Overall, oxacillin-resistance was 55.1%, especially among S. epidermidis, while all isolates were susceptible to vancomycin, teicoplanin, tigecyclin, rifampin, trimethoprim/sulfamethoxazole, linezolid, moxifloxacin, tobramycin and gentamicin. Coagulase-negative staphylococci were the most frequently isolated and S. epidermidis was largely the main single agent. Only four Gram negatives caused polymicrobial infections with Staphylococci. Despite improvements in CIED design and implantation techniques, infection of cardiac devices remains a serious problem.
authors.affiliation: Department of Biomedical and Biotechnological Sciences, Division of Microbiology, University of Catania, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Salmeri
authors.affiliation: CCD G.B. Morgagni, Centro Cuore Morgagni, Catania, Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Sorbello
authors.affiliation: Department of Biomedical and Biotechnological Sciences, Division of Microbiology, University of Catania, Italy.
authors.forename: Silvana
authors.initials: S
authors.lastname: Mastrojeni
authors.affiliation: CCD G.B. Morgagni, Centro Cuore Morgagni, Catania, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Santanocita
authors.affiliation: CCD G.B. Morgagni, Centro Cuore Morgagni, Catania, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Milazzo
authors.affiliation: CCD G.B. Morgagni, Centro Cuore Morgagni, Catania, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Stefano
authors.affiliation: Department G.F. Ingrassia, University of Catania, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Scalia
authors.affiliation: Department of Biomedical and Biotechnological Sciences, Division of Microbiology, University of Catania, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Addamo
authors.affiliation: Department of Biomedical and Biotechnological Sciences, Division of Microbiology, University of Catania, Italy.
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Toscano
authors.affiliation: Department of Biomedical and Biotechnological Sciences, Division of Microbiology, University of Catania, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Stefani
authors.affiliation: Department of Biomedical and Biotechnological Sciences, Division of Microbiology, University of Catania, Italy.
authors.forename: Maria Lina
authors.initials: ML
authors.lastname: Mezzatesta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D018441:Biofilms; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000382:microbiology; D060085:Coinfection; D020878:Device Removal; D004352:Drug Resistance, Microbial; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D006782:Hospitals, Special; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000382:microbiology*; D012008:Recurrence; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents