Are drug-resistant infections affecting more heart device leads?

20th April 2016

Drug-resistant infections necessitating the removal of heart device leads are on the rise, suggests a new study from America.

More than two thirds of the infections affecting people with internal defibrillators (ICDs) and pacemakers were from the staphylococcal species, including MRSA.

Nearly half (49.4%) of staphylococci were resistant to the penicillin (methicillin) designed to treat it, which accounted for 33.8% of overall infections.

Less common were infections from streptococci (2.5%), enterococci (4.2%), anaerobes (1.6%), fungi (0.9%), and mycobacteria species (0.2%), said the researchers, including Dr Khaldoun Tarakji from the Cleveland Clinic, and colleagues.

"The rates of methicillin resistance appear to be higher than those reported from the preceding decade," the investigators wrote in their study published online in Journal of the American College of Cardiology: Clinical Electrophysiology.

"Overall, these signals of increasing methicillin resistance organisms may reflect the common inappropriate use of broad spectrum antibiotics and suggest acquisition of culprit organisms in health care environments," they suggested.

Dr Tarakji's study included 816 consecutive patients who had their device leads extracted between 2000 and 2011. Infections were detected in 86.8% of patients.

Pocket infections made up half of all device-related infections and were split evenly between those occurring within and beyond one year after pocket manipulation.

Late-onset pocket infections were related to less virulent staphylococci that were likely acquired at the time of device placement.

For more details about the study, see here

For more on staphylococcal infections see here