John de Heide

PADIT-score and device infection in pacemaker or defibrillator surgery 103 Table 2 – Details of CIED infection requiring hospitalization. Case Age/ sex PADIT- score Index procedure CIED infection Timing (days after procedure) Causative pathogen Management 1 45/ F 5 Pacemaker implantation Pocket infection 4 - Complete system removal, cefuroxime iv, reimplantation single chamber pacemaker contralateral side 2 34 / F 7 ICD generator change (no CRT) Pocket infection 13 CNS Complete system removal with TLE, flucloxacillin iv, reimplantation subcutaneous ICD 3 65 / F 4 ICD implantation Pocket infection 20 S. aureus Clindamycin oral, pocket revision with Tyrx envelope 4 69/ M 9 CRT-D generator change Pocket infection 21 S. epidermidis Complete system removal with TLE, no antibiotics, no reimplantation due to LVEF 49% 5 55/ M 4 ICD implantation Systemic CIED infection 24 S. aureus Complete system removal, flucloxacillin iv, reimplantation dual chamber ICD after antibiotic treatment 6 42 / F 2 Pacemaker implantation Systemic CIED infection 29 S. aureus Complete system removal, flucloxacillin iv, reimplantation dual chamber pacemaker contralateral side 7 72/ M 8 CRT-D generator change Pocket infection 31 S. aureus Complete system removal with TLE, flucloxacillin oral, reimplantation CRT-D with antibiotic envelope contralateral side 8 19/ M 4 ICD implantation Pocket infection 33 K. variicola Complete system removal, no antibiotics, reimplantation dual chamber ICD contralateral side 9 65 / F 7 ICD generator change (no CRT) Systemic CIED infection 146 E. faecalis Complete system removal with TLE, amoxicillin iv, ceftriaxone iv, reimplantation subcutaneous ICD 10 65/ M 9 Upgrade to ICD Systemic CIED infection 260 E. faecalis Complete system removal with TLE, vancomycin iv, no reimplantation due to improved systolic left ventricular function Cases are ordered based on timing of hospitalization for CIED infection. Abbreviations: AB = antibiotic therapy; CIED = cardiac implantable electronic device; CNS = coagulase-negative staphylococci; TLE = transvenous lead extraction. 6

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