Temporary trends of cardiac device related infective endocarditis in a tertiary referral center between 2006 and 2022

• Published in: Europace (London, England) England), 2023-05, Vol.25 (Supplement_1)
• Main Authors: Denes, M, Bence, A, Matus, M, Kolossvary, M, Foldesi, C S, Vertesaljai, M
• Format: Article
• Language: English
• ISSN: 1099-5129; 1532-2092
• DOI: 10.1093/europace/euad122.639

Abstract Funding Acknowledgements Type of funding sources: None. Background Infective endocarditis (IE) is a rare, but life-threatening complication of cardiac device implantation. Despite recent preventive strategies and advances in antimicrobial and surgical treatment, morbidity and mortality rates are still high. Aims The objective of our study was to assess the epidemiological characteristics, temporal trends and mortality rates of cardiac device related IE (CDRIE) in our high-volume, tertiary referral center. Methods retrospective data collection was performed between January 1, 2006 and March 31, 2022. Median follow-up was 3.8 yrs (IQR: 0.6 – 9.2 yrs). Patients admitted between 2006 and 2013 (group 1) and between 2014 and 2022 (group 2) were compared to assess temporal trends. Thirty-day, 6-month and 1-year mortality rates were estimated. Results During the observed 17 years 82 patients were admitted with CDRIE (61 males [74%]), mean age: 57.3 ±18 yrs; 6 VVI, 7 VDD, 17 VVI-ICD, 24 DDD, 10 DDD-ICD and 18 CRT devices [4 CRT-P, 14 CRT-D]); median time since first implantation was 3.8 yrs [IQR: 1.1 – 6.6 yrs]). Staphylococci were the most prevalent infective agents (62%), S. aureus (SA) infection was found in 37 cases (out of whom 13 were MRSA [16%]), coagulase negative Staphylococcus in 14 cases (17%), Enterococcus faecalis in 9 cases (11%), streptococci in 4 cases (5%), blood culture was negative in 13 cases (15%), and in 5 cases other pathogens were the underlying microorganism. Patients in Group 1 (n=42) did not differ from patients in Group 2 (n=40) in terms of age, male gender or ejection fraction. Patients in Group 2 had higher CRP level at admission (42,9 [IQR:34-55] mmol/l vs 90 [IQR:25-60] mmol/l, p=0.02). ICD lead (29% vs 67%, p