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Clinical utility of sonication for diagnosing infection and colonization of cardiovascular implantable electronic devices

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Abstract

Our study aimed to evaluate the sensitivity of the sonication tool for the microbiological diagnosis of cardiovascular implantable electronic device infections (CIEDIs). The extracted cardiac implants of 52 patients were assessed: 19 with CIEDI and 33 with elective generator replacement or revision without clinical infection. Sonication fluid culture of explanted CIEDs yielded higher numbers of microorganisms than pocket tissue or swab cultures. The sensitivity of sonication fluid culture was significantly higher than that of pocket swab and tissue culture for microbiological diagnosis of CIEDI. The microorganisms isolated most frequently via sonication of explanted CIEDs were Gram-positive cocci (70%), of which 50% was coagulase-negative Staphylococcus. Sonication fluid culture detected colonization in 36.4% of the non-infected patients. Sonication fluid culture represents a promising diagnostic strategy with increased sensitivity compared to conventional culture methods for microbiological diagnosis of cardiac devices associated with infection and colonization.

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Abbreviations

CRTDs:

Cardiac resynchronization devices

CIEDIs:

Cardiovascular implantable electronic device infections

CIEDs:

Cardiovascular implantable electronic devices

CoNS:

Coagulase-negative Staphylococcus

CFU:

Colony-forming units

CIs:

Confidence intervals

ICDs:

Implantable cardiovascular defibrillators

LVEF:

Left ventricular ejection fraction

MRSA:

Methicillin-resistant Staphylococcus aureus

NICIEDs:

Non-infected CIEDs

PPMs:

Permanent pacemakers

PTC:

Pocket tissue culture

SCF:

Sonicate fluid culture

SWC:

Swab culture

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Funding

No specific funding was secured for this article.

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Authors and Affiliations

  1. Medical Microbiology and Immunology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

    Amira H. El-Ashry

  2. Cardiovascular Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

    Mohammed Salah A. Hussein

  3. Pediatrics, Faculty of Medicine, Assiut University, Assiut, 71516, Egypt

    Khaled Saad

  4. Department of Community Health Nursing, Faculty of Nursing, Assiut University, Assiut, Egypt

    Amira El Elhoufey

  5. Department of Community Health Nursing, Alddrab University College, Jazan University, Jazan, Kingdom of Saudi Arabia

    Amira El Elhoufey

Authors
  1. Amira H. El-Ashry
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  2. Mohammed Salah A. Hussein
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  3. Khaled Saad
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  4. Amira El Elhoufey
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Contributions

MSAH, AHE, KS conceptualized and designed the study protocol development, assessment, and writing the manuscript. MSAH, KS and AE designed the data collection instrument and coordinated and supervised data collection and statistical analysis. AHE performed laboratory analysis. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Khaled Saad.

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There is no conflict of interest for this study.

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Edited by: Jordi Vila.

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El-Ashry, A.H., Hussein, M.S.A., Saad, K. et al. Clinical utility of sonication for diagnosing infection and colonization of cardiovascular implantable electronic devices. Med Microbiol Immunol 210, 245–250 (2021). https://doi.org/10.1007/s00430-021-00717-2

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  • DOI: https://doi.org/10.1007/s00430-021-00717-2

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