TY - JOUR
T1 - Risk factors for Gram-negative bacterial infection of cardiovascular implantable electronic devices
T2 - multicentre observational study (CarDINe Study)
AU - CarDINe Study Group
AU - Pascale, Renato
AU - Toschi, Alice
AU - Aslan, Abdullah Tarik
AU - Massaro, Giulia
AU - Maccaro, Angelo
AU - Fabbricatore, Davide
AU - Dell'Aquila, Andrea
AU - Ripa, Marco
AU - Işık, Mehmet Emirhan
AU - Kızmaz, Yeşim Uygun
AU - Iacopino, Saverio
AU - Camici, Marta
AU - Perna, Francesco
AU - Akinosoglou, Karolina
AU - Karruli, Arta
AU - Papadimitriou-Olivgeris, Matthaios
AU - Kayaaslan, Bircan
AU - Bilir, Yeşim Aybar
AU - Evren Özcan, Emin
AU - Turan, Oğuzhan Ekrem
AU - Işık, Muhammed Cihan
AU - Pérez-Rodríguez, María Teresa
AU - Yagüe, Belén Loeches
AU - Quirós, Alejandro Martín
AU - Yılmaz, Mesut
AU - Petersdorf, Sabine
AU - De Potter, Tom
AU - Durante-Mangoni, Emanuele
AU - Akova, Murat
AU - Curnis, Antonio
AU - Gibertoni, Dino
AU - Diemberger, Igor
AU - Scudeller, Luigia
AU - Viale, Pierluigi
AU - Giannella, Maddalena
AU - Caroccia, Natascia
AU - Fanì, Francesca
AU - Arbizzani, Federica
AU - Ramanathan, Ramsiya
AU - Scarpellini, Paolo
AU - Marzi, Alessandra
AU - Mazzone, Patrizio
AU - Placentino, Filippo
AU - Sammarini, Giulia
AU - Tenti, Elena
AU - Leventopulos, George
AU - Domenichini, Giulia
AU - Şahin, Meyha
AU - Suárez-Varela, Milagros
AU - Villegas, Elkin González
N1 - Publisher Copyright:
© 2023 The Authors
PY - 2023/3
Y1 - 2023/3
N2 - Background: Infections of cardiovascular implantable electronic devices (CIED) are mainly due to Gram-positive bacteria (GPB). Data about Gram-negative bacteria CIED (GNB-CIED) infections are limited. This study aimed to investigate risk factors, clinical and diagnostic characteristics, and outcome of patients with GNB-CIED. Methods: A multicentre, international, retrospective, case-control-control study was performed on patients undergoing CIED implantation from 2015 to 2019 in 17 centres across Europe. For each patient diagnosed with GNB-CIED, one matching control with GPB-CIED infection and two matching controls without infection were selected. Results: A total of 236 patients were enrolled: 59 with GNB-CIED infection, 59 with GPB-CIED infection and 118 without infection. No between-group differences were found regarding clinical presentation, diagnostic and therapeutic management. A trend toward a higher rate of fluorodeoxyglucose positron emission computed tomography (FDG PET/CT) positivity was observed among patients with GNB than in those with GPB-CIED infection (85.7% vs. 66.7%; P = 0.208). Risk factors for GNB-CIED infection were Charlson Comorbidity Index Score (relative risk reduction, RRR = 1.211; P = 0.011), obesity (RRR = 5.122; P = 0.008), ventricular-pacing ventricular-sensing inhibited-response pacemaker implantation (RRR = 3.027; P = 0.006) and right subclavian vein site of implantation (RRR = 5.014; P = 0.004). At 180-day survival analysis, GNB-CIED infection was associated with increased mortality risk (HR = 1.842; P = 0.067). Conclusions: Obesity, high number of comorbidities and right subclavian vein implantation site were associated with increased risk of GNB-CIED infection. A prompt therapeutic intervention that may be guided using FDG PET/CT is suggested in patients with GNB-CIED infection, considering the poorer outcome observed in this group.
AB - Background: Infections of cardiovascular implantable electronic devices (CIED) are mainly due to Gram-positive bacteria (GPB). Data about Gram-negative bacteria CIED (GNB-CIED) infections are limited. This study aimed to investigate risk factors, clinical and diagnostic characteristics, and outcome of patients with GNB-CIED. Methods: A multicentre, international, retrospective, case-control-control study was performed on patients undergoing CIED implantation from 2015 to 2019 in 17 centres across Europe. For each patient diagnosed with GNB-CIED, one matching control with GPB-CIED infection and two matching controls without infection were selected. Results: A total of 236 patients were enrolled: 59 with GNB-CIED infection, 59 with GPB-CIED infection and 118 without infection. No between-group differences were found regarding clinical presentation, diagnostic and therapeutic management. A trend toward a higher rate of fluorodeoxyglucose positron emission computed tomography (FDG PET/CT) positivity was observed among patients with GNB than in those with GPB-CIED infection (85.7% vs. 66.7%; P = 0.208). Risk factors for GNB-CIED infection were Charlson Comorbidity Index Score (relative risk reduction, RRR = 1.211; P = 0.011), obesity (RRR = 5.122; P = 0.008), ventricular-pacing ventricular-sensing inhibited-response pacemaker implantation (RRR = 3.027; P = 0.006) and right subclavian vein site of implantation (RRR = 5.014; P = 0.004). At 180-day survival analysis, GNB-CIED infection was associated with increased mortality risk (HR = 1.842; P = 0.067). Conclusions: Obesity, high number of comorbidities and right subclavian vein implantation site were associated with increased risk of GNB-CIED infection. A prompt therapeutic intervention that may be guided using FDG PET/CT is suggested in patients with GNB-CIED infection, considering the poorer outcome observed in this group.
KW - CIED infection
KW - Cardiovascular implantable electronic devices
KW - Endocarditis
KW - FDG PET/CT
KW - Gram-negative
UR - https://www.scopus.com/pages/publications/85149069850
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=performanshacettepe&SrcAuth=WosAPI&KeyUT=WOS:000946704400001&DestLinkType=FullRecord&DestApp=WOS_CPL
U2 - 10.1016/j.ijantimicag.2023.106734
DO - 10.1016/j.ijantimicag.2023.106734
M3 - Article
C2 - 36690123
AN - SCOPUS:85149069850
SN - 0924-8579
VL - 61
JO - International Journal of Antimicrobial Agents
JF - International Journal of Antimicrobial Agents
IS - 3
M1 - 106734
ER -
SDG 3 Good Health and Well-being