Bluhm G L
Scand J Thorac Cardiovasc Surg. 1985;19(3):231-5. doi: 10.3109/14017438509102724.
To evaluate the long-term effect of systemic antibiotic prophylaxis at pacemaker surgery, an analysis was made of infections in 272 patients submitted to 303 consecutive pacemaker operations. The follow-up time was 24-33 months. Antibiotic prophylaxis had been given in all cases. The overall infection rate was 4.0%: The incidence after new implant was 3.8%, generator replacement 2.4%, electrode replacement 15% and early reoperation 4.2%, with the only statistically significant difference between electrode replacement and generator replacement. The interval between operation and appearance of infection was 3 days to 18 months. The causal microorganisms were methicillin-resistant Staphylococcus epidermidis in four patients, methicillin-sensitive S. epidermis in one patient and methicillin-sensitive S. aureus in three. An anaerobic gram-positive coccus was cultured in one patient and a nonenteric gram-negative rod in another. Five infections were cured by antibiotic treatment alone, but in seven cases surgery was also needed. The incidence of infection was significantly increased when potential predisposing factors--diabetes mellitus, postoperative hematoma and use of a temporary electrode--were present.
为评估起搏器手术中全身应用抗生素预防的长期效果，对272例接受303次连续起搏器手术患者的感染情况进行了分析。随访时间为24至33个月。所有病例均给予了抗生素预防。总体感染率为4.0%：新植入后感染发生率为3.8%，发生器更换为2.4%，电极更换为15%，早期再次手术为4.2%，电极更换与发生器更换之间仅有统计学上的显著差异。手术至感染出现的间隔时间为3天至18个月。致病微生物为4例耐甲氧西林表皮葡萄球菌、1例甲氧西林敏感表皮葡萄球菌和3例甲氧西林敏感金黄色葡萄球菌。1例患者培养出厌氧革兰氏阳性球菌，另1例患者培养出非肠道革兰氏阴性杆菌。5例感染仅通过抗生素治疗治愈，但7例还需要手术治疗。当存在潜在的诱发因素——糖尿病、术后血肿和使用临时电极时，感染发生率显著增加。
