Pacemaker-associated infection caused by ST81/SCCmec IV methicillin-resistant, vancomycin-intermediate Staphylococcus aureus in Japan

A 76-year-old Japanese man was admitted to hospital for treatment of fever and skin lesion at the implantation site of his pacemaker. During his hospitalization, vancomycin-intermediate Staphylococcus aureus (MIC 4 μg/mL) with reduced susceptibility to daptomycin was isolated from venous blood. This isolate was identified as methicillin-resistant S. aureus with SCCmec IV and was genotyped as sequence type 81, coa VIIa and spa type t7044, harbouring blaZ, aac(6′)-aph(2″) and enterotoxin(-like) genes sea, seb, sek, sel, selx and selw. The patient was successfully treated with daptomycin, minocycline and sulfamethoxazole/trimethoprim. We describe the identification of sequence type 81/SCCmec IV vancomycin-intermediate S. aureus from pacemaker-associated septicaemia.

[Follow-up of Patients with Cardiac Pacemakers]

Follow-up of Patients with Cardiac Pacemakers Abstract. General practitioners play a central role for patients with cardiac pacemakers (PM) because they are mostly the first medical professionals confronted with PM problems. Acute dyspnea, dizzy spells/fainting or infection of the device pocket are red flags in the first weeks after PM implantation and warrant urgent workup. Symptoms late after PM implantation are less overtly associated with the PM. Routine follow-up examinations include an inspection of the PM pocket and an ECG, which has to be interpreted with the knowledge of the PM function and PM programming. Frequently, a PM interrogation will be necessary to achieve a correct diagnosis and initiate the appropriate management.