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Prevention Bundle May Cut Cardiac Device Infections

WEDNESDAY, June 26, 2019 -- Standardized protocols and bundles can improve infection prevention in the electrophysiology laboratory, according to a study published online June 4 in Infection Control & Hospital Epidemiology.

Archana Asundi, M.D., from Boston Medical Center, and colleagues used data from the VA Clinical Assessment Reporting and Tracking-Electrophysiology database (fiscal years 2008 through 2015) to assess receipt of infection prevention interventions and the incidence of six-month, procedure-related cardiac implantable electronic device (CIED) infections.

The researchers identified 101 procedure-related CIED infections among 2,098 procedures (4.8 percent). Increased odds of infections were associated with wound complications (adjusted odds ratio [aOR], 8.74), revisions including generator changes (aOR, 2.4), an elevated international normalized ratio (>1.5; aOR, 1.56), and methicillin-resistant Staphylococcus colonization (aOR, 9.56). Preprocedural skin cleaning with chlorhexidine versus other topical agents (aOR, 0.41) and receipt of β-lactam antimicrobial prophylaxis versus vancomycin (aOR, 0.6) were clinically effective prevention interventions. There was no reduced infection risk associated with use of mesh pockets and continuation of antimicrobial prophylaxis after skin closure.

"These findings regarding the real-world clinical effectiveness of different prevention strategies can be applied to the development of evidence-based protocols and infection prevention guidelines specific to the electrophysiology laboratory," conclude the authors.

Two authors disclosed ties to pharmaceutical companies.

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Posted: June 2019

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