Cardiac Arrhythmia Center at the Heart Center of Ludwigshafen, Bremserstrasse 79, Ludwigshafen D-67063, Germany.
Europace. 2010 Jan;12(1):58-63. doi: 10.1093/europace/eup334.
This study was designed to evaluate the prevalence of bacterial colonization of generator pockets in implantable cardioverter defibrillator (ICD) patients without signs of infection and to analyse the impact of bacterial colonization on the incidence of device infection during follow-up.
In 122 ICD patients undergoing generator replacement or surgical lead revision between January 2006 and July 2008, microbiological cultures of generator pockets and extracted leads were consecutively obtained. Patients with clinical evidence of a device infection were excluded. Positive cultures from the generator pocket and leads were found in 40 (33%) patients. The most common bacteria isolated were coagulase negative staphylococci (68%). During a median follow-up time of 203 days after the revision device infection occurred in three [7.5%, confidence interval (CI) 1.6-20.4%] patients with a positive culture vs. two (2.4%, CI 0.3-8.5%) patients with a negative culture (P = 0.33). Time from revision to infection was 108 +/- 73 days in patients with positive culture vs. 60 +/- 39 days in patients with negative culture (P = 0.50).
A third of ICD patients undergoing generator replacement or lead revision have an asymptomatic bacterial colonization of generator pockets. After revision 7.5% of these patients develop a device infection with the same species of microorganism.
本研究旨在评估无感染迹象的植入式心脏复律除颤器（ICD）患者发生器袋细菌定植的发生率，并分析细菌定植对随访期间器械感染发生率的影响。
在 2006 年 1 月至 2008 年 7 月期间接受发生器更换或外科导线修正的 122 例 ICD 患者中，连续获得发生器袋和提取导线的微生物培养物。排除有器械感染临床证据的患者。在 40 例（33%）患者的发生器袋和导线上发现了阳性培养物。分离出的最常见细菌是凝固酶阴性葡萄球菌（68%）。在修正后中位随访 203 天期间，3 例（7.5%，置信区间 [CI] 1.6-20.4%）阳性培养患者发生感染，2 例（2.4%，CI 0.3-8.5%）阴性培养患者发生感染（P = 0.33）。阳性培养患者的感染时间为 108 +/- 73 天，阴性培养患者的感染时间为 60 +/- 39 天（P = 0.50）。
三分之一接受发生器更换或导线修正的 ICD 患者发生器袋存在无症状细菌定植。修正后，这些患者中有 7.5%发生了与相同微生物种类的器械感染。
