Chu Xian-Ming, Li Bing, An Yi, Li Xue-Bin, Guo Ji-Hong
Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao 266100, China.
Department of Biology, Medical College of Qingdao University, Qingdao 266021, China.
Biomed Res Int. 2014;2014:725163. doi: 10.1155/2014/725163. Epub 2014 Nov 2.
Asymptomatic bacterial colonization of cardiovascular implantable electronic devices (CIEDs) is widespread and increases the risk of clinical CIED infection. The aim of the study was to evaluate the incidence of bacterial colonization of generator pockets in patients without signs of infection and to analyze the relationship with clinical infection and risk factors. From June 2011 to December 2012, 78 patients underwent CIED replacement or upgrade. Exclusion criteria included a clinical diagnosis of CIED infection, bacteremia, or infective endocarditis. All patients were examined for evidence of bacterial 16S rDNA on the device and in the surrounding tissues. Infection cases were recorded during follow-up. The bacterial-positive rate was 38.5% (30 cases); the coagulase-negative Staphylococcus detection rate was the highest (9 cases, 11.5%). Positive bacterial DNA results were obtained from pocket tissue in 23.1% of patients (18 cases), and bacterial DNA was detected on the device in 29.5% of patients (23 cases). During follow-up (median 24.6 months), two patients (6.7%, 2/30) became symptomatic with the same species of microorganism, S. aureus and S. epidermidis. Multivariable logistic regression analysis found that the history of bacterial infection, use of antibiotics, application of antiplatelet drugs, replacement frequency, and renal insufficiency were independent risk factors for asymptomatic bacterial colonization.
心血管植入式电子设备（CIEDs）的无症状细菌定植很普遍，会增加CIED临床感染的风险。本研究的目的是评估无感染迹象患者发生器囊袋细菌定植的发生率，并分析其与临床感染及危险因素的关系。2011年6月至2012年12月，78例患者接受了CIED更换或升级。排除标准包括CIED感染、菌血症或感染性心内膜炎的临床诊断。所有患者均检查了设备及周围组织中细菌16S rDNA的证据。随访期间记录感染病例。细菌阳性率为38.5%（30例）；凝固酶阴性葡萄球菌检出率最高（9例，11.5%）。23.1%的患者（18例）在囊袋组织中获得阳性细菌DNA结果，29.5%的患者（23例）在设备上检测到细菌DNA。随访期间（中位时间24.6个月），两名患者（6.7%，2/30）出现由相同微生物金黄色葡萄球菌和表皮葡萄球菌引起的症状。多变量逻辑回归分析发现，细菌感染史、抗生素使用、抗血小板药物应用、更换频率和肾功能不全是无症状细菌定植的独立危险因素。
