dc.contributor.author |
Cyr, Derek |
|
dc.contributor.author |
Fowler, Vance Garrison Jr |
|
dc.contributor.author |
Maskarinec, Stacey A |
|
dc.contributor.author |
Ruffin, Felicia |
|
dc.contributor.author |
Souli, Maria |
|
dc.contributor.author |
Thaden, Joshua |
|
dc.date.accessioned |
2018-07-16T17:27:34Z |
|
dc.date.available |
2018-07-16T17:27:34Z |
|
dc.date.issued |
2017-01 |
|
dc.identifier |
ofx132 |
|
dc.identifier.issn |
2328-8957 |
|
dc.identifier.issn |
2328-8957 |
|
dc.identifier.uri |
https://hdl.handle.net/10161/17241 |
|
dc.description.abstract |
The species-specific risk of cardiac device-related infection (CDRI) among bacteremic
patients is incompletely understood.We conducted a prospective cohort study of hospitalized
patients from October 2002 to December 2014 with a cardiac device (CD) and either
Staphylococcus aureus bacteremia (SAB) or Gram-negative bacteremia (GNB). Cardiac
devices were defined as either prosthetic heart valves (PHVs), including valvular
support rings, permanent pacemakers (PPMs)/automatic implantable cardioverter defibrillators
(AICDs), or left ventricular assist devices (LVADs).During the study period, a total
of 284 patients with ≥1 CD developed either SAB (n = 152 patients) or GNB (n = 132
patients). Among the 284 patients, 150 (52.8%) had PPMs/AICDs, 72 (25.4%) had PHVs,
4 (1.4%) had LVADs, and 58 (20.4%) had >1 device present. Overall, 54.6% of patients
with SAB and 16.7% of patients with GNB met criteria for definite CDRI (P < .0001).
Multivariable logistic regression analysis revealed that 3 bacterial species were
associated with an increased risk for CDRI: Staphylococcus aureus (odds ratio [OR]
= 5.57; 95% confidence interval [CI], 2.16-14.36), Pseudomonas aeruginosa (OR = 50.28;
95% CI, 4.16-606.93), and Serratia marcescens (OR = 7.75; 95% CI, 1.48-40.48).Risk
of CDRI among patients with bacteremia varies by species. Cardiac device-related infection
risk is highest in patients with bacteremia due to S aureus, P aeruginosa, or S marcescens.
By contrast, it is lower in patients with bacteremia due to other species of Gram-negative
bacilli. Patients with a CD who develop bacteremia due to either P aeruginosa or S
marcescens should be considered for diagnostic imaging to evaluate for the presence
of CDRI.
|
|
dc.language |
eng |
|
dc.publisher |
OXFORD UNIV PRESS INC |
|
dc.relation.ispartof |
Open forum infectious diseases |
|
dc.relation.isversionof |
10.1093/ofid/ofx132 |
|
dc.subject |
Gram-negative bacteremia |
|
dc.subject |
S aureus bacteremia |
|
dc.subject |
cardiac device-related infection |
|
dc.subject |
pacemaker infection |
|
dc.subject |
prosthetic valve endocarditis |
|
dc.title |
The Risk of Cardiac Device-Related Infection in Bacteremic Patients Is Species Specific:
Results of a 12-Year Prospective Cohort.
|
|
dc.type |
Journal article |
|
dc.date.updated |
2018-07-16T17:27:32Z |
|
pubs.begin-page |
ofx132 |
|
pubs.issue |
3 |
|
pubs.organisational-group |
School of Medicine |
|
pubs.organisational-group |
Duke |
|
pubs.organisational-group |
Duke Clinical Research Institute |
|
pubs.organisational-group |
Institutes and Centers |
|
pubs.organisational-group |
Molecular Genetics and Microbiology |
|
pubs.organisational-group |
Basic Science Departments |
|
pubs.organisational-group |
Medicine, Infectious Diseases |
|
pubs.organisational-group |
Medicine |
|
pubs.organisational-group |
Clinical Science Departments |
|
pubs.publication-status |
Published |
|
pubs.volume |
4 |
|