Identification of bacteriology and risk factor analysis of asymptomatic bacterial colonization in pacemaker replacement patients

Recent researches revealed that asymptomatic bacterial colonization on PMs might be ubiquitous and increase the risk of clinical PM infection. Early diagnosis of patients with asymptomatic bacterial colonization could provide opportunity for targeted preventive measures. The present study explores t...

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Bibliographic Details
Published in:PloS one 2015-03, Vol.10 (3), p.e0119232-e0119232
Main Authors: Chu, Xian-Ming, Yu, Hua, Sun, Xue-Xia, An, Yi, Li, Bing, Li, Xue-Bin
Format: Article
Language:English
Subjects:
Aged
Antibiotics
Bacteria
Bacterial infections
Bacteriology
Biofilms
Cardiology
Cardiovascular disease
Coagulase
Colonization
Culture
Deoxyribonucleic acid
DNA
Drugs
Endocarditis
Factor analysis
Factor Analysis, Statistical
Family medical history
Female
Generators
Genetic screening
Genetic testing
Health aspects
Health risks
Heart
Hospitals
Humans
Incidence
Infection
Infections
Laboratories
Male
Pacemaker, Artificial - microbiology
Patients
Prosthesis-Related Infections - epidemiology
Prosthesis-Related Infections - etiology
Prosthesis-Related Infections - microbiology
Regression analysis
Risk analysis
Risk Assessment - methods
Risk Factors
RNA
RNA, Ribosomal, 16S - genetics
rRNA 16S
Staphylococcal Infections - epidemiology
Staphylococcal Infections - etiology
Staphylococcal Infections - microbiology
Staphylococcus aureus
Staphylococcus aureus - genetics
Surgery
Tissues
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Summary:Recent researches revealed that asymptomatic bacterial colonization on PMs might be ubiquitous and increase the risk of clinical PM infection. Early diagnosis of patients with asymptomatic bacterial colonization could provide opportunity for targeted preventive measures. The present study explores the incidence of bacterial colonization of generator pockets in pacemaker replacement patients without signs of infection, and to analyze risk factors for asymptomatic bacterial colonization. From June 2011 to December 2013, 118 patients underwent pacemaker replacement or upgrade. Identification of bacteria was carried out by bacterial culture and 16S rRNA sequencing. Clinical risk characteristics were analyzed. The total bacterial positive rate was 37.3% (44 cases), and the coagulase-negative Staphylococcus aureus detection rate was the highest. Twenty two (18.6%) patients had positive bacterial culture results, of which 50% had coagulase-negative staphylococcus. The bacterial DNA detection rate was 36.4 % (43 cases). Positive bacterial DNA results from pocket tissues and the surface of the devices were 22.0% and 29.7%, respectively. During follow-up (median, 27.0 months), three patients (6.8%, 3/44) became symptomatic with the same genus of microorganism, S. aureus (n=2) and S. epidermidis (n=1). Multivariable logistic regression analysis showed that history of bacterial infection, use of antibiotics, application of antiplatelet drugs, replacement frequency were independent risk factors for asymptomatic bacterial colonization. There was a high incidence of asymptomatic bacterial colonization in pacemaker patients with independent risk factors. Bacterial culture combined genetic testing could improve the detection rate.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0119232