Approach to Diagnosis of Cardiovascular Implantable-Electronic-Device Infection

Journal of Clinical Microbiology - Tập 56 Số 7 - 2018
Daniel C. DeSimone1,2, M. Rizwan Sohail1,2
1Department of Cardiovascular Diseases, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
2Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA

Tóm tắt

ABSTRACT Device infection remains a significant challenge as clinical indications for cardiovascular implantable electronic device (CIED) therapy continue to expand beyond the prevention and treatment of cardiac arrhythmias. Patients receiving CIED therapy are now older and have significant comorbidities, placing them at higher risk of complications, including infection. CIED infection warrants complete device removal, as retention is associated with an unacceptably high risk of relapse and increased mortality. However, accurate diagnosis of CIED infections remains a significant challenge that is based on a combination of findings on physical examination, microbiological and laboratory testing, and advanced imaging, such as transesophageal echocardiography or positron emission tomography. Isolating a causative pathogen and performing susceptibility testing are crucial for appropriate choice, route, and duration of antimicrobial therapy. In this review, we present an evidence-based approach to diagnosis of CIED infection.

Từ khóa


Tài liệu tham khảo

10.1016/j.jacc.2011.04.033

10.1093/cid/cix181

10.1161/CIRCEP.111.962753

10.1146/annurev.mi.48.100194.003101

10.7326/0003-4819-133-8-200010170-00011

10.1161/CIRCULATIONAHA.109.192665

10.1016/j.jacc.2007.01.072

10.1016/j.hrthm.2016.08.029

10.1093/jac/dku383

10.1016/j.amjcard.2015.01.017

10.1111/j.1540-8159.2005.00268.x

10.1111/j.1540-8159.2008.02257.x

10.1093/europace/eus044

10.1016/j.ijid.2015.07.018

10.1111/pace.12529

10.1111/j.1540-8159.2010.02820.x

10.1128/JCM.02230-12

10.1161/CIRCULATIONAHA.109.906461

10.1016/j.jcmg.2013.08.001

10.2967/jnumed.111.099424

10.1016/j.jacc.2011.11.059

10.1093/ehjci/jeu295

10.1161/CIRCIMAGING.116.005772

10.2967/jnumed.116.173690

10.1007/s12350-017-1063-0

10.1371/journal.pone.0172384