Diagnosis Of Cardiac Device Infection Research Articles

Detection of Biofilm-associated Implant Pathogens in Cardiac Device Infections: High Sensitivity of Sonication Fluid Culture Even in the Presence of Antimicrobials.

Introduction:Sonication showed more sensitivity than traditional culture in the diagnosis of device infections. Aims of the study were to assess the role of sonication in the microbiological diagnosis and management of cardiac device infections (CDIs), to evaluate the sensitivity of sonication in patients on antimicrobial therapy at the time of device removal, and to analyze biofilm formation of the isolated strains.Materials and Methods:A total of 90 devices (31 generators and 59 electrodes) collected from 31 patients with infection underwent sonication before culture. Devices were sonicated for 5 min and centrifuged at 3200 rpm for 15 min. Intraoperative traditional cultures were performed in 26 patients. Microorganisms were identified using conventional methods. Staphylococcal strains were tested for slime production.Results:Microbiological diagnosis was achieved in 28 patients (90%). Sonicate fluid was positive in 68/90 (76%) of devices (27/31 [87%] generators and 41/59 [69%] electrodes), whereas intraoperative pocket swabs grew bacteria in 10/26 patients (38%, P = 0.0007). Among leads, 37/59 (62.7%) yielded bacteria even in the absence of vegetation. Coagulase-negative Staphylococci accounted for 83.8% (57/68) of the total; Staphylococcus aureus and Gram-negative bacilli were found in 4.4% (3/68) and 5.8% (4/68), respectively. Biofilm production was present in 15/22 (69%) staphylococcal strains. Overall, patients on therapy (n = 23) had a microbiological diagnosis in 20/23 (86.9%) and 7/22 (30.4%) through sonication and intraoperative cultures, respectively (P = 0.0002).Discussion:Our data showed the high sensitivity of sonication in the diagnosis of CDIs, even in patients under antimicrobial therapy.Conclusion:Sonication represents an essential tool for both diagnosis and management of CDIs.

Radionuclide Imaging of Cardiac Device Infection

Purpose of Review Accurate diagnosis of cardiac device infection is critical for clinical decision-making and represents a challenge for current diagnostic methods. A non-invasive test with sufficient sensitivity and specificity to confirm or exclude infection would be desirable. 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) has been emerging as a promising diagnostic tool for cardiac implantable electrophysiological devices (CIED) infection and its complications. The aim of this review is to describe the role of radionuclide imaging in cardiac device infection according to the different clinical presentations.

555 18F-FDG PET/CT as a new imaging modality for diagnosis of cardiac device infections (PET-ID)

555 18F-FDG PET/CT as a new imaging modality for diagnosis of cardiac device infections (PET-ID)

Corynebacterium jeikeium pacemaker infection associated with antineutrophil cytoplasmic antibodies: a single positive blood culture could be sufficient for diagnosis

Corynebacterium jeikeium, a member of the non-diphtheria corynebacteria, has been rarely reported as being responsible for cardiovascular-device infection. Here, we report what is believed to be the first case of C. jeikeium pacemaker infection associated with the presence of proteinase-3 antineutrophil cytoplasmic antibodies. The diagnosis was established based on the positivity of a single positive blood culture and led to pacemaker extraction. This observation highlights the difficulty in the diagnosis of cardiac-device infection in the presence of a single positive blood culture with a fastidious microorganism that could be considered as a contaminant. It also underscores the need for device extraction to ensure healing.

Implantable Cardioverter-Defibrillator Infection Due to Brucella melitensis: Case Report and Review of Brucellosis of Cardiac Devices

We report a case of implantable cardioverter-defibrillator infection due to Brucella melitensis and review 5 previously reported cases of Brucella infection of cardiac devices. Device removal, followed by antibiotic therapy for 6 weeks, is probably required for cure. Although rare, reports of Brucella infection of prosthetic implants and devices have increased in the past decade. Brucellosis should be considered in the differential diagnosis of cardiac device infection in patients residing in or traveling to areas of endemicity.