Abstract：
Cardiovascular implantable electronic device (CIED) implantation has markedly increased over the past 2 decades. Staphylococcus aureus bacteremia (SAB) occurs in patients with CIED, and determination of device infection often is difficult.
The purpose of this study was to examine the rate and clinical characteristics of SAB in patients living with CIED using the 2019 European Heart Rhythm Association (EHRA) international consensus document.
We conducted a retrospective study of patients with CIED who were hospitalized at Mayo Clinic, Rochester, with SAB from 2012 to 2019. Patients who met CIED infection criteria after SAB based on EHRA criteria were identified. A descriptive statistic and time-dependent Cox model were used.
Overall, 110 patients with CIED developed SAB, of whom 92 (83.6%) underwent transesophageal echocardiogram (TEE). Fifty-seven (51.8%) and 31 (28.2%) patients met criteria for definite and possible CIED infections, respectively. At 30-day follow-up, the cumulative rate of patients undergoing complete device extraction was 80.0% in the definite CIED infection group, compared with 38.8% and 32.9% in the possible and rejected CIED infection groups, respectively. We found that CIED extraction was associated with an 83% reduction in risk of 1-year mortality in the definite CIED infection group.
The rate of CIED infections after SAB was higher than that reported previously. Increased use of TEE and a novel case definition with broader diagnostic criteria likely were operative, in part, in accounting for the higher rate of CIED infections complicating SAB. Complete device removal is critical in patients with definite CIED infection to improve 1-year mortality.
The purpose of this study was to examine the rate and clinical characteristics of SAB in patients living with CIED using the 2019 European Heart Rhythm Association (EHRA) international consensus document.
We conducted a retrospective study of patients with CIED who were hospitalized at Mayo Clinic, Rochester, with SAB from 2012 to 2019. Patients who met CIED infection criteria after SAB based on EHRA criteria were identified. A descriptive statistic and time-dependent Cox model were used.
Overall, 110 patients with CIED developed SAB, of whom 92 (83.6%) underwent transesophageal echocardiogram (TEE). Fifty-seven (51.8%) and 31 (28.2%) patients met criteria for definite and possible CIED infections, respectively. At 30-day follow-up, the cumulative rate of patients undergoing complete device extraction was 80.0% in the definite CIED infection group, compared with 38.8% and 32.9% in the possible and rejected CIED infection groups, respectively. We found that CIED extraction was associated with an 83% reduction in risk of 1-year mortality in the definite CIED infection group.
The rate of CIED infections after SAB was higher than that reported previously. Increased use of TEE and a novel case definition with broader diagnostic criteria likely were operative, in part, in accounting for the higher rate of CIED infections complicating SAB. Complete device removal is critical in patients with definite CIED infection to improve 1-year mortality.
摘要：
在过去的20年中，心血管可植入电子设备（CIED）的植入显着增加。金黄色葡萄球菌菌血症（SAB）发生在CIED患者中，和设备感染的确定往往是困难的。
这项研究的目的是使用2019年欧洲心律协会（EHRA）国际共识文件，检查患有CIED的患者中SAB的发生率和临床特征。
我们对在梅奥诊所住院的CIED患者进行了回顾性研究，罗切斯特,2012年至2019年与SAB合作。确定基于EHRA标准的SAB后符合CIED感染标准的患者。使用描述性统计和时间依赖性Cox模型。
总的来说，110例CIED患者发展为SAB，其中92人(83.6%)接受了经食管超声心动图(TEE)检查。57例（51.8%）和31例（28.2%）患者符合明确和可能的CIED感染标准，分别。在30天的随访中，在明确的ED感染组中，接受完全摘除装置的患者的累积率为80.0%，与可能和拒绝CIED感染组的38.8%和32.9%相比，分别。我们发现，在定义的CIED感染组中，CIED提取与1年死亡率降低83%相关。
SAB后CIED感染率高于先前报道。TEE使用的增加和具有更广泛诊断标准的新病例定义可能是手术，在某种程度上,在解释SAB并发CIED感染率较高方面。对于明确ED感染的患者，完全摘除装置对于提高1年死亡率至关重要。
这项研究的目的是使用2019年欧洲心律协会（EHRA）国际共识文件，检查患有CIED的患者中SAB的发生率和临床特征。
我们对在梅奥诊所住院的CIED患者进行了回顾性研究，罗切斯特,2012年至2019年与SAB合作。确定基于EHRA标准的SAB后符合CIED感染标准的患者。使用描述性统计和时间依赖性Cox模型。
总的来说，110例CIED患者发展为SAB，其中92人(83.6%)接受了经食管超声心动图(TEE)检查。57例（51.8%）和31例（28.2%）患者符合明确和可能的CIED感染标准，分别。在30天的随访中，在明确的ED感染组中，接受完全摘除装置的患者的累积率为80.0%，与可能和拒绝CIED感染组的38.8%和32.9%相比，分别。我们发现，在定义的CIED感染组中，CIED提取与1年死亡率降低83%相关。
SAB后CIED感染率高于先前报道。TEE使用的增加和具有更广泛诊断标准的新病例定义可能是手术，在某种程度上,在解释SAB并发CIED感染率较高方面。对于明确ED感染的患者，完全摘除装置对于提高1年死亡率至关重要。
