Risk of Cardiac Device-Associated Infection in Bacteremic Patients Is Species-Specific: Results From a 10-Year Prospective Cohort

Abstract Background The species-specific risk of cardiac device-related infection (CDRI) among bacteremic patients is incompletely understood. Methods We conducted a prospective cohort study of hospitalized patients from October 2002 to December 2014 with a cardiac device (CD) and either Staphylococcus aureus bacteremia (SAB) or Gram-negative bacteremia (GNB). Cardiac devices were defined as either prosthetic heart valves (PHVs), including valvular support rings, permanent pacemakers (PPMs)/automatic implantable cardioverter defibrillators (AICDs), or left ventricular assist devices (LVADs). Results During the study period, a total of 284 patients with ≥1 CD developed either SAB (n = 152 patients) or GNB (n = 132 patients). Among the 284 patients, 150 (52.8%) had PPMs/AICDs, 72 (25.4%) had PHVs, 4 (1.4%) had LVADs, and 58 (20.4%) had >1 device present. Overall, 54.6% of patients with SAB and 16.7% of patients with GNB met criteria for definite CDRI (P < .0001). Multivariable logistic regression analysis revealed that 3 bacterial species were associated with an increased risk for CDRI: Staphylococcus aureus (odds ratio [OR] = 5.57; 95% confidence interval [CI], 2.16–14.36), Pseudomonas aeruginosa (OR = 50.28; 95% CI, 4.16–606.93), and Serratia marcescens (OR = 7.75; 95% CI, 1.48–40.48). Conclusions Risk of CDRI among patients with bacteremia varies by species. Cardiac device-related infection risk is highest in patients with bacteremia due to S aureus, P aeruginosa, or S marcescens. By contrast, it is lower in patients with bacteremia due to other species of Gram-negative bacilli. Patients with a CD who develop bacteremia due to either P aeruginosa or S marcescens should be considered for diagnostic imaging to evaluate for the presence of CDRI.

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Electron Microscopy in the Study of Natural Phytoplankton Assemblages

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100119831 ◽

1985 ◽

Vol 43 ◽

pp. 620-623

Author(s):

Linda Sicko-Goad

Keyword(s):

Electron Microscopy ◽

Aquatic Environment ◽

Size Range ◽

Physical Parameters ◽

Specific Information ◽

Phytoplankton Assemblages ◽

Phytoplankton Productivity ◽

Ecosystem Effects ◽

Time Of Year ◽

Species Specific

Although the use of electron microscopy and its varied methodologies is not usually associated with ecological studies, the types of species specific information that can be generated by these techniques are often quite useful in predicting long-term ecosystem effects. The utility of these techniques is especially apparent when one considers both the size range of particles found in the aquatic environment and the complexity of the phytoplankton assemblages.The size range and character of organisms found in the aquatic environment are dependent upon a variety of physical parameters that include sampling depth, location, and time of year. In the winter months, all the Laurentian Great Lakes are uniformly mixed and homothermous in the range of 1.1 to 1.7°C. During this time phytoplankton productivity is quite low.

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