Cardiac device infection

Serious infection with increasing incidence.

Risk factors for CDI include: malnutrition, malignancy, diabetes, skin disorders, use of immunosuppressive drug and corticosteroids, and anticoagulants.

Procedural factors that affect risk include type of device, duration of implant, generator replacement history, presence of sternal or systemic infections.

Management includes removal of the device, ptolonged antibiotics, and possible replacement of the device.

Cardiac device infection with endocarditis has a higher mortality than cardiac infection without endocarditis.

Patients with CDI endocarditis are more likely to be male, older, and diabetic than patients with infective endocarditis with no cardiac devices.

Cardiac device infective endocarditis accounts for about 6.4% of all cases of infective endocarditis.

Cardiac device infectious endocarditis involves skin contamination at the time of implantation or arises later from the generator site.

Cardiac device infective endocarditis predominantly associated with staphylococci.

Majority of cardiac device infections affect the subcutaneous generator pocket.

10-20% of subcutaneous generator pocket infections result in infectious endocarditis.

Cardiac device infectious endocarditis occurs between .06% and 0.6% per year, a 1.14 per 1000 device years (Uslan DZ et al).

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