CIED infection with either pocket or systemic infection presentation – complete device removal and long-term antibiotic treatment; long-term outcome

Figures & data

Table I. Demographics of all patients and divided into patients presenting with systemic or pocket presentation as defined in the text.

	Total	Systemic	Pocket	p-Value
Age, year (mean ± SD)	64 ± 15	62 ± 13	66 ± 16	0.33
Sex, female, n (%)	17 (24)	8 (25)	9 (23)	0.85
BMI (Kg/m^2)	26 ± 5	26 ± 6	26 ± 4	0.86
IHD, n (%)	27 (38)	10 (31)	17 (44)	0.29
CABG, n (%)	9 (13)	3 (9)	6 (15)	0.45
Hypertension, n (%)	22 (31)	8 (25)	14 (36)	0.32
Diabetes, n (%)	12 (31)	6 (19)	6 (15)	0.71
Nephropathy, n (%)	17 (24)	9 (28)	8 (21)	0.75
Prosthetic valve, n (%)	12 (17)	3 (9)	9 (23)	0.13
LVEF %, (mean ± SD)	39 ± 17	39 ± 17	43 ± 16	0.29

p-Value is referring to the difference between systemic and pocket group. IHD, ischeamic heart disease, CABG, coronary artery bypass graft, LVEF, left ventricle ejection fraction.

Table II. Type of device implanted and type of latest procedure before the current CIED infection divided into patients with systemic or pocket presentation as defined in the text.

Device type	Total	Systemic	Pocket	p-Value
Permanent pacemaker, n (%)	45 (63)	19 (59)	26 (67)	Ns
Implantable cardioverter-defibrilator,  n (%)	17 (24)	10 (31)	7 (18)	Ns
Cardiac resynchronization therapy  device, n (%)	9 (13)	3 (9)	6 (15)	Ns
Type of latest procedure
De novo implantation, n (%)	22 (31)	12 (38)	11 (29)	Ns
Revision, upgrade, generator  exchange, n (%)	49 (69)	20 (63)	27 (71)	Ns

p-Value is referring to the difference between systemic and pocket group. NS = non significant.

Figure 1. Time distribution from the last procedure to the presence of CIED infection divided into systemic or pocket presentation. The pocket presentation was more frequent in the “early” period (from 0 to 12 months) as compared to the “late” period (from 12 to 36 month) but only borderline statistically significant, p = 0.07.

Figure 2. Distribution of bacterias cultured from blood, device pocket and device leads.

Table III. Specification of “other” bacterias from Figure 2.

Bacteria	Blood	Pocket	Lead
Probionebacteria acnes	1	9	8
Pseudomonas aeruginosa		2	3
Escherichia coli	1	1
Corynebacteria sp		1	2
Enterococcus faecalis		1	1
Neisseria sp		1
Morganella morganii	1		1
Bacillus species			1
Klebsiella oxytoca		1

Figure 3. Kaplan–Meyer plot of mortality. Upper part all patients, lower part depicts mortality divided into the two subgroups defined, pocket and systemic. Equal mortality was noted in the two groups systemic vs. pocket group, p = 0.48.