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布鲁氏菌性心脏植入式电子设备感染:一项单中心病例系列研究。

Brucella cardiac implantable electronic device infection: A single-center case series.

作者信息

Elzein Fatehi, Alsufyani Eid, Al Hebaishi Yahya, Mosaad Mohammed, Alqurashi Moayad, Al Fagih Ahmed

机构信息

Infectious Diseases Unit, Prince Sultan Military Medical City, P.O. Box 7897, Riyadh, 11159, Saudi Arabia.

Prince Sultan Cardiac Center, Riyadh, Saudi Arabia.

出版信息

Ann Med Surg (Lond). 2021 Jul 16;68:102568. doi: 10.1016/j.amsu.2021.102568. eCollection 2021 Aug.

Abstract

BACKGROUND

Cardiac implantable electronic devices (CIEDs), including implantable cardiac defibrillators, pacemakers, and cardiac resynchronization therapy devices, are lifesaving. However, device infections can lead to morbidity and mortality. of this study was to describe the outcome of CIED infections treated at our center, and to identify risk factors for infection in patients with CIEDs. : Single-center study, Prince Sultan Military Medical City, Riyadh, KSA.

METHODS

This case series included all -related CIED infections treated at a tertiary care center between 2009 and 2020. Data on patient demographics, clinical manifestations, predisposing factors, microbiology, treatment regimens, and outcomes were reviewed.

RESULTS

Fifteen patients met the CIED infection criteria. The mean age was 62.2 years, and 80% were males. Common comorbidities included hypertension (73%), diabetes mellitus (67%), ischemic heart disease (47%), and chronic kidney disease (60%). The mean time to infection following the device implantation was 4.8 years (range: 5 months to 13 years). Fever was detected in 53% of patients, device site swelling in 47%, purulent discharge in 33%, and pain in 27%. The blood culture and serology results were positive in 73% and 80% of patients, respectively. All patients were treated with antibiotics, and the infected device was removed. Seven (46.6%) patients underwent reimplantation with a new device. One patient with dual and methicillin-sensitive infection died, and the other 14 patients recovered, with no recurrent infections reported to date.

CONCLUSION

should be considered in CIED infections, particularly in endemic areas. Proper treatment and device removal are essential for good outcomes.

摘要

背景

心脏植入式电子设备(CIEDs),包括植入式心脏除颤器、起搏器和心脏再同步治疗设备,可挽救生命。然而,设备感染可导致发病和死亡。本研究的目的是描述在我们中心治疗的CIED感染的结果,并确定CIED患者感染的危险因素。地点:沙特阿拉伯利雅得苏丹王子军事医疗城单中心研究。

方法

本病例系列包括2009年至2020年在三级护理中心治疗的所有与CIED相关的感染。回顾了患者人口统计学、临床表现、易感因素、微生物学、治疗方案和结果的数据。

结果

15名患者符合CIED感染标准。平均年龄为62.2岁,80%为男性。常见合并症包括高血压(73%)、糖尿病(67%)、缺血性心脏病(47%)和慢性肾病(60%)。设备植入后至感染的平均时间为4.8年(范围:5个月至13年)。53%的患者检测到发热,47%的患者出现设备部位肿胀,33%的患者有脓性分泌物,27%的患者有疼痛。血培养和血清学结果分别在73%和80%的患者中呈阳性。所有患者均接受抗生素治疗,并移除感染的设备。7名(46.6%)患者接受了新设备的重新植入。一名患有双腔CIED且感染耐甲氧西林金黄色葡萄球菌的患者死亡,其他14名患者康复,迄今为止未报告复发性感染。

结论

CIED感染时应考虑[具体内容缺失],特别是在流行地区。适当的治疗和设备移除对于取得良好结果至关重要。

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