The Risk of Cardiac Device-Related Infection in Bacteremic Patients Is Species Specific: Results of a 12-Year Prospective Cohort.

Maskarinec, Stacey A

Thaden, Joshua T

Cyr, Derek D

Ruffin, Felicia

Souli, Maria

Fowler, Vance G

2018-07-16T17:27:34Z

2018-07-16T17:27:34Z

2017-01

2018-07-16T17:27:32Z

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.

ofx132

2328-8957

2328-8957

https://hdl.handle.net/10161/17241

eng

Oxford University Press (OUP)

Open forum infectious diseases

10.1093/ofid/ofx132

Gram-negative bacteremia

S aureus bacteremia

cardiac device-related infection

pacemaker infection

prosthetic valve endocarditis

The Risk of Cardiac Device-Related Infection in Bacteremic Patients Is Species Specific: Results of a 12-Year Prospective Cohort.

Journal article

Thaden, Joshua T|0000-0002-3250-0697

Ruffin, Felicia|0000-0003-2176-6462

Fowler, Vance G|0000-0002-8048-0897

ofx132

3

School of Medicine

Duke

Duke Clinical Research Institute

Institutes and Centers

Molecular Genetics and Microbiology

Basic Science Departments

Medicine, Infectious Diseases

Medicine

Clinical Science Departments

Published

4