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Microbial diagnosis of infection and colonization of cardiac implantable electronic devices by use of sonication.
Inacio, Ricardo Cantarim; Klautau, Giselle Burlamaqui; Murça, Maria Aparecida S; da Silva, Cely Barreto; Nigro, Stanley; Rivetti, Luiz Antonio; Pereira, Wilson Lopes; Salles, Mauro Jose Costa.
Afiliação
  • Inacio RC; Emergency Service, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil.
  • Klautau GB; Department of Internal Medicine, Division of Infectious Diseases, Santa Casa de São Paulo School of Medical Sciences, Rua Dr Cesáreo Mota Jr 112, CEP 01303-060, São Paulo, SP, Brazil.
  • Murça MA; Department of Laboratory Medicine and Pathology, Division of Infectious Diseases, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil.
  • da Silva CB; Department of Laboratory Medicine and Pathology, Division of Infectious Diseases, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil.
  • Nigro S; Department of Laboratory Medicine and Pathology, Division of Infectious Diseases, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil.
  • Rivetti LA; Department of Surgery, Division of Infectious Diseases, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil.
  • Pereira WL; Department of Surgery, Division of Infectious Diseases, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil.
  • Salles MJ; Department of Internal Medicine, Division of Infectious Diseases, Santa Casa de São Paulo School of Medical Sciences, Rua Dr Cesáreo Mota Jr 112, CEP 01303-060, São Paulo, SP, Brazil. Electronic address: mcsalles@osite.com.br.
Int J Infect Dis ; 38: 54-9, 2015 Sep.
Article em En | MEDLINE | ID: mdl-26216762
OBJECTIVES: The clinical utility of sonication as an adjunctive diagnostic tool for the microbial diagnosis of cardiac implantable device-associated infections (CIDAIs) was investigated. METHODS: The implants of 83 subjects were investigated, 15 with a CIDAI and 68 without a clinical infection. Clinical data were analyzed prospectively and sonication fluid cultures (83 patients, 100%) and traditional cultures (31 patients, 37.4%) were performed RESULTS: Generator pocket infection and device-related endocarditis were found in 13 (86.7%) and four (26.7%) subjects, respectively. The mean numbers of previous technical complications and infections were higher in the infected patients compared to the non-infected patients (8 vs. 1, p<0.001; 2 vs. 0, p<0.031, respectively). The sensitivity and specificity for detecting CIDAI was 73.3% (11/15) and 48.5% (33/68) for sonication fluid culture, and 26.7% (4/15) and 100% (16/16) for traditional culture (p<0.001), respectively. A higher number of organisms were identified by sonication fluid than by tissue culture (58 vs. 4 specimens; p<0.001). The most frequent organisms cultured were Gram-positive cocci (66.1%), mainly coagulase-negative staphylococci (35.5%). Thirty-five (51.5%) non-infected subjects were considered colonized due to the positive identification of organisms exclusively through sonication fluid culture. CONCLUSIONS: Sonication fluid culture from the removed cardiac implants has the potential to improve the microbiological diagnosis of CIDAIs.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Marca-Passo Artificial / Sonicação / Infecções Relacionadas à Prótese / Desfibriladores Implantáveis / Endocardite Bacteriana Tipo de estudo: Diagnostic_studies / Prognostic_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Int J Infect Dis Assunto da revista: DOENCAS TRANSMISSIVEIS Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Brasil País de publicação: Canadá

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Marca-Passo Artificial / Sonicação / Infecções Relacionadas à Prótese / Desfibriladores Implantáveis / Endocardite Bacteriana Tipo de estudo: Diagnostic_studies / Prognostic_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Int J Infect Dis Assunto da revista: DOENCAS TRANSMISSIVEIS Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Brasil País de publicação: Canadá