Abstract 17222: MRSA Infection is Associated With Worse Outcomes After Device Infection

Abstract

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) is more virulent compared with other bacteria. Data regarding outcomes after transvenous lead extraction (TLE) for device infection with various staphylococcal and non-staphylococcal species are lacking Hypothesis: We hypothesized that MRSA infection is associated with worse outcomes after TLE for device infection compared with other infections Methods: We collected data for all patients undergoing TLE for infectious indication between April 2004 and June 2015. Patients were divided into 5 groups- group 1 had MRSA infection, group 2 had methicillin-sensitive Staphylococcous aureus (MSSA), group 3 had coagulase-negative Staphylococcus (CoNS), group 4 had non-staphylococcal infection and group 5 were culture negative. Results: Out of total 700 TLE procedures for infectious indication, 134 (19.1%) had MRSA, 143 (20.4%) had MSSA, 229 (32.7%) had CoNS, 109 (15.6%) had other bacterial infections and 59 (8.4%) were culture negative. Pocket infection was more commonly associated with CoNS (40.3%) and negative cultures (18.2%). Systemic infection was unlikely to be associated with negative cultures (2.9%) and equally distributed among other 4 groups.There was no difference in procedural outcomes between the groups. Complications during hospital stay were equally common with MRSA, MSSA and CoNS infections (22.5%, 27.2%, 24.9%, respectively) and less common with other infections (16.2%) and culture negative group (9.2%). Kaplan-Meier survival curves showed worse mortality with MRSA, compared with other infections. MRSA and MSSA have similar worse mortality up to 9 months, after which curves diverge and continue to diverge up to 4 years follow up. Conclusions: MRSA and MSSA infections are associated with worse mortality up to 9 months after TLE for device infection. After 9 months, MRSA infection is associated with worse mortality and curve continues to diverge up to 4 years follow-up.