Division of Infectious Diseases, 200 First Street SW, Rochester, MN 55905, USA.
Expert Rev Anti Infect Ther. 2010 Jul;8(7):831-9. doi: 10.1586/eri.10.54.
Cardiovascular implantable electronic device (CIED) implantation rate has substantially risen in the foregoing decades. Unfortunately, this upsurge in CIED implantation rate has been accompanied by a disproportionate rise in the rate of CIED infections. Device infection is a major complication of CIED implantation, necessitating removal of an infected device followed by systemic antimicrobial therapy and reimplantation of a new system. In this article, we review the current epidemiology, risk factors, diagnostic strategy and contemporary management of CIED infection. In addition, we address the vexing question of how to best manage patients with Staphylococcus aureus bacteremia, in the setting of an implanted device, but no overt clinical signs of CIED infection. Lastly, we discuss the preventive strategies to minimize risk of CIED infection.
在过去的几十年中，心血管植入式电子设备（CIED）的植入率大幅上升。不幸的是，CIED 植入率的上升伴随着 CIED 感染率的不成比例上升。器械感染是 CIED 植入的主要并发症，需要取出感染的器械，然后进行全身抗菌治疗，并重新植入新的系统。本文综述了 CIED 感染的当前流行病学、危险因素、诊断策略和现代治疗方法。此外，我们还探讨了如何最好地处理在植入器械的情况下患有金黄色葡萄球菌菌血症但没有明显的 CIED 感染临床症状的患者这一棘手问题。最后，我们讨论了预防策略，以最大程度地降低 CIED 感染的风险。
