Kennergren Charles
Sahlgrenska University Hospital, Gothenburg, Sweden.
Arrhythm Electrophysiol Rev. 2015 May;4(1):53-7. doi: 10.15420/aer.2015.4.1.53. Epub 2015 Apr 10.
The incidence of infection following implantation of cardiovascular implantable electronic devices (CIEDs) is increasing, as is the number of pulse generator replacements and upgrades. The rate of infections is rising faster than the rate of device implantation, mainly due to the increasing age and number of comorbidities of patients receiving the devices. Patients with a CIED infection usually require hospitalisation, multiple consultations, prolonged intravenous antibiotics and, in the majority of cases, CIED explantation and replacement. A significant proportion die of their infection. CIED infection therefore represents a substantial health and economic burden, and management of infections is critical. Numerous risk factors have been identified including host, procedure and device-related factors. Established strategies for preventing CIED infections include intravenous antibiotics and aseptic techniques. The TYRX™ Absorbable Antibacterial Envelope offers potential as an effective method to reduce CIED infections. Several studies have found a statistically significant association between antibacterial envelope use and reduced incidence of CIED infection in high-risk patients. A prospective, randomised trial to further evaluate this potentially important strategy for CIED infection prophylaxis is underway.
心血管植入式电子设备（CIED）植入后感染的发生率正在上升，脉冲发生器更换和升级的数量也在增加。感染率的上升速度快于设备植入率，主要原因是接受设备治疗的患者年龄增长和合并症数量增加。CIED感染患者通常需要住院、多次会诊、长时间静脉使用抗生素，而且在大多数情况下，需要取出并更换CIED。相当一部分患者死于感染。因此，CIED感染构成了巨大的健康和经济负担，感染的管理至关重要。已确定了许多风险因素，包括宿主、手术和与设备相关的因素。预防CIED感染的既定策略包括静脉使用抗生素和无菌技术。TYRX™可吸收抗菌包膜有望成为减少CIED感染的有效方法。多项研究发现，在高危患者中，使用抗菌包膜与CIED感染发生率降低之间存在统计学上的显著关联。一项进一步评估这一潜在重要的CIED感染预防策略的前瞻性随机试验正在进行中。
