Application of an Infection Control Protocol (ICP) Reduced Cardiac Device Infection (CDI) in Low-Volume Centers

BACKGROUND: Cardiac device infection (CDI) is a serious complication of cardiovascular implantable electronic device (CIED) implantations. Many risk factors have been identified, but several are still uncertain. This study aimed to identify and evaluate the risk factors. Moreover, an infection control protocol (ICP) was carried out, and its efficacy in reducing CDIs was investigated. MATERIAL/METHODS: A total of 1259 patients who received permanent pacemaker (PPM) implantations were enrolled in this study in a 3-year period in a high-volume center and low-volume centers in the central area of Shaanxi Province, China. Follow-up data of all enrolled patients were collected. The risk factors for CDIs were identified and analyzed. The ICP was adopted in the low-volume centers. Data, including CDI rates, medical costs, and microbiology, were collected and compared. RESULTS: Male gender, diabetes, CKD, operation duration, PPM replacement, and low center volume were identified as the risk factors for CDIs. Furthermore, CDI rates in low-volume centers were significantly higher than in high-volume centers. The adoption of an ICP dramatically reduced CDI rates in low-volume centers without significant increases in medical costs. CONCLUSIONS: ICPs were easily carried out, effective, and economical in controlling CDIs in low-volume centers, which was identified as a risk factor of CDIs.