Replacement of CRT-D infection

I am happy to report I am home after a 2-week unplanned and very difficult stay in the hospital.

I had very complicated repositioning surgery and unexpected replacement surgery (due to device not functioning properly) of my CRT-D in mid December.  At my bandage and staple removal about 10 days later the wound was still open and actively bleeding upon bandage removal.  I was put on antibiotics, and after bleeding the following day, I was admitted through the ED.  I had surgery the next morning to clean out the chest cavity, remove a large hematoma, and cultures were taken.  Fortunately, no blood cultures taken in the ED grew bacteria.  Of the numerous cutltures taken from the chest from the hematoma and one from the chest cavity grew bacteria.  Additional blood cultures were taken several days later and no additional bacteria grew, which was a huge relief to all! I was treated with 2 different antibiotics when I was admitted and it was changed when the bacteria was identified. Fortunately, the bacteria, Pseudonomas putida, continues to be treated and I got released today.  

I see my EP Friday (a different hospital from the repositioning/replacement surgery was performed, and the EP and surgeon, who used to work together, remained in contact with my case).  I have a CRT-D that badly needs adjusting and arrhythmias to be addressed. 



replacement infection

by new to pace.... - 2023-01-11 22:13:12

Sorry to hear IslandGirl  you had to go through all that.  Glad to hear you are finally home and starting to mend.

new to pace

I am glad you are home at last

by Gemita - 2023-01-12 06:43:55

Dear Islandgirl, 

I am so sorry to hear that you had to spend so much time in hospital after developing an infection following your complicated repositioning surgery and unexpected replacement surgery due to a poorly functioning device.  

Thank you for telling us about the bacterium present.  I am glad it was found and that you are being treated with the appropriate antibiotic. I see that Pseudonomas putida produces an infection with higher prevalence in patients weakened by other conditions/trauma and after medical device implants.  It usually presents as skin and soft tissue infection, pneumonia, urinary infection or bacteremia. 

Pseudonomas putida is a bacterium that can promote formation of a biofilm (a biofilm is like a well-protected burrow where bacteria hibernate). This creates a barrier against antibiotics. But this defensive barrier also limits the penetration of oxygen and food. Bacteria located in the deepness of the biofilm will start starving. In medical device-related infections, microorganisms adhere to materials and biofilm development is accelerated.

Prognosis of P. putida bacteremia is usually good providing an effective antibiotic is given and any infected medical implant or dead or infected skin tissue is removed quickly.  I have no doubt that you will be followed up closely Islandgirl from now on to make sure that you remain infection free.

I hope your EP will be able to help adjust your CRT-D quickly when you see him and that your arrhythmias can be calmed, although after the trauma you have just experienced, I can imagine your arrhythmias are pretty active at the moment which of course won't be helping.

I send my best wishes as always and hope that this time you are finally on the road to recovery?  Good luck when you see your EP

Aw hugs!

by Lavender - 2023-01-12 11:25:21

What a scary journey you've been on!  I'm so relieved to know that things were fixed. It sounds like your present medical team is on top of things! May God speed your healing and calm your mind after experiencing all of this trauma!💐

Thank you for your encouragement

by islandgirl - 2023-01-12 22:31:56

Thank you all for your encouragement and knowledge/help.   

I am hoping the oral antibiotic I am taking is not lengthening my already long QT wave.  I am taking only 1/2 of my regular dose of sotalol antiarrhythmic--down to 80 mg and my regular dose is 160 mg and 120 mg.  If so, I would have to be put on IV antibiotics.  I found there is only 1 oral and 4 IV antibotics available for this infection.

I know I am good hands with my cardio thoracic surgeon, as the infectious disease team said he is one of the authors of a publication regarding treating device infections.  Those 2 groups worked as a great as a team. 

I'll keep you updated on my appt tomorrow with my EP.  

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