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Cardiac implantable electronic device infection in the cardiac referral center in Thailand: incidence, microbiology, risk factors, and outcomes
BACKGROUND: Despite the long experience of cardiac implantable electronic device (CIED) implantation in Thailand, epidemiology of CIED infection in Thailand has never been studied. METHODS: A retrospective cohort study was conducted at the cardiac referral center in Thailand to investigate incidence...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6288561/ https://www.ncbi.nlm.nih.gov/pubmed/30555607 http://dx.doi.org/10.1002/joa3.12123 |
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author | Korkerdsup, Theerawat Ngarmukos, Tachapong Sungkanuparph, Somnuek Phuphuakrat, Angsana |
author_facet | Korkerdsup, Theerawat Ngarmukos, Tachapong Sungkanuparph, Somnuek Phuphuakrat, Angsana |
author_sort | Korkerdsup, Theerawat |
collection | PubMed |
description | BACKGROUND: Despite the long experience of cardiac implantable electronic device (CIED) implantation in Thailand, epidemiology of CIED infection in Thailand has never been studied. METHODS: A retrospective cohort study was conducted at the cardiac referral center in Thailand to investigate incidence of CIED infection and causative organisms between October 2002 and December 2017. A matched case‐control study was performed to determine the factors associated with CIED infection. RESULTS: Incidence of CIED infection was 0.9% with a stable trend during the studied period. There were 54 episodes of CIED infection. The median (interquartile range) age of the patients was 67.5 (53.0‐75.0) years. A total of 29 (53.7%), 18 (33.3%), and 7 (13.0%) were permanent pacemaker, automatic implantable cardioverter‐defibrillator, and cardio‐resynchronization therapy‐related infection, respectively. Gram‐positive cocci were the most common organism (24 episodes, 44.4%). Gram‐negative bacilli were isolated in six episodes (11.1%). About 9.3% were polymicrobial and 35.2% were culture negative. Multivariate analysis showed that previous CIED infection and generator revision procedure were associated with CIED infection (odds ratio [OR] 48.56, 95% confidence interval [CI] 3.72‐633.62; P = 0.003 and OR 19.99, 95% CI 1.28‐333.24; P = 0.033 respectively). Forty (74.1%) cases were cured. Leaving device in situ was the only factor significantly associated with poor outcome (OR 11.40, 95% CI 1.52‐85.73; P = 0.018). CONCLUSIONS: In Thailand, while CIED implantation is rising, incidence of CIED infection is stable. Microbiology of CIED infection in Thailand is similar to western countries, albeit a higher proportion of negative culture. Previous CIED infection and generator revision procedure are associated with CIED infection. |
format | Online Article Text |
id | pubmed-6288561 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-62885612018-12-14 Cardiac implantable electronic device infection in the cardiac referral center in Thailand: incidence, microbiology, risk factors, and outcomes Korkerdsup, Theerawat Ngarmukos, Tachapong Sungkanuparph, Somnuek Phuphuakrat, Angsana J Arrhythm Original Articles BACKGROUND: Despite the long experience of cardiac implantable electronic device (CIED) implantation in Thailand, epidemiology of CIED infection in Thailand has never been studied. METHODS: A retrospective cohort study was conducted at the cardiac referral center in Thailand to investigate incidence of CIED infection and causative organisms between October 2002 and December 2017. A matched case‐control study was performed to determine the factors associated with CIED infection. RESULTS: Incidence of CIED infection was 0.9% with a stable trend during the studied period. There were 54 episodes of CIED infection. The median (interquartile range) age of the patients was 67.5 (53.0‐75.0) years. A total of 29 (53.7%), 18 (33.3%), and 7 (13.0%) were permanent pacemaker, automatic implantable cardioverter‐defibrillator, and cardio‐resynchronization therapy‐related infection, respectively. Gram‐positive cocci were the most common organism (24 episodes, 44.4%). Gram‐negative bacilli were isolated in six episodes (11.1%). About 9.3% were polymicrobial and 35.2% were culture negative. Multivariate analysis showed that previous CIED infection and generator revision procedure were associated with CIED infection (odds ratio [OR] 48.56, 95% confidence interval [CI] 3.72‐633.62; P = 0.003 and OR 19.99, 95% CI 1.28‐333.24; P = 0.033 respectively). Forty (74.1%) cases were cured. Leaving device in situ was the only factor significantly associated with poor outcome (OR 11.40, 95% CI 1.52‐85.73; P = 0.018). CONCLUSIONS: In Thailand, while CIED implantation is rising, incidence of CIED infection is stable. Microbiology of CIED infection in Thailand is similar to western countries, albeit a higher proportion of negative culture. Previous CIED infection and generator revision procedure are associated with CIED infection. John Wiley and Sons Inc. 2018-09-27 /pmc/articles/PMC6288561/ /pubmed/30555607 http://dx.doi.org/10.1002/joa3.12123 Text en © 2018 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Heart Rhythm Society. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Articles Korkerdsup, Theerawat Ngarmukos, Tachapong Sungkanuparph, Somnuek Phuphuakrat, Angsana Cardiac implantable electronic device infection in the cardiac referral center in Thailand: incidence, microbiology, risk factors, and outcomes |
title | Cardiac implantable electronic device infection in the cardiac referral center in Thailand: incidence, microbiology, risk factors, and outcomes |
title_full | Cardiac implantable electronic device infection in the cardiac referral center in Thailand: incidence, microbiology, risk factors, and outcomes |
title_fullStr | Cardiac implantable electronic device infection in the cardiac referral center in Thailand: incidence, microbiology, risk factors, and outcomes |
title_full_unstemmed | Cardiac implantable electronic device infection in the cardiac referral center in Thailand: incidence, microbiology, risk factors, and outcomes |
title_short | Cardiac implantable electronic device infection in the cardiac referral center in Thailand: incidence, microbiology, risk factors, and outcomes |
title_sort | cardiac implantable electronic device infection in the cardiac referral center in thailand: incidence, microbiology, risk factors, and outcomes |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6288561/ https://www.ncbi.nlm.nih.gov/pubmed/30555607 http://dx.doi.org/10.1002/joa3.12123 |
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