{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T11:52:26Z","timestamp":1780573946347,"version":"3.54.1"},"reference-count":38,"publisher":"Cambridge University Press (CUP)","issue":"8","license":[{"start":{"date-parts":[[2019,6,4]],"date-time":"2019-06-04T00:00:00Z","timestamp":1559606400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X19001272_as1\"><jats:title>Objective:<\/jats:title><jats:p>To measure the association between receipt of specific infection prevention interventions and procedure-related cardiac implantable electronic device (CIED) infections.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19001272_as2\"><jats:title>Design:<\/jats:title><jats:p>Retrospective cohort with manually reviewed infection status.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19001272_as3\"><jats:title>Setting:<\/jats:title><jats:p>Setting: National, multicenter Veterans Health Administration (VA) cohort.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19001272_as4\"><jats:title>Participants:<\/jats:title><jats:p>Sampling of procedures entered into the VA Clinical Assessment Reporting and Tracking-Electrophysiology (CART-EP) database from fiscal years 2008 through 2015.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19001272_as5\"><jats:title>Methods:<\/jats:title><jats:p>A sample of procedures entered into the CART-EP database underwent manual review for occurrence of CIED infection and other clinical\/procedural variables. The primary outcome was 6-month incidence of CIED infection. Measures of association were calculated using multivariable generalized estimating equations logistic regression.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19001272_as6\"><jats:title>Results:<\/jats:title><jats:p>We identified 101 procedure-related CIED infections among 2,098 procedures (4.8% of reviewed sample). Factors associated with increased odds of infections included (1) wound complications (adjusted odds ratio [aOR], 8.74; 95% confidence interval [CI], 3.16\u201324.20), (2) revisions including generator changes (aOR, 2.4; 95% CI, 1.59\u20133.63), (3) an elevated international normalized ratio (INR) &gt;1.5 (aOR, 1.56; 95% CI, 1.12\u20132.18), and (4) methicillin-resistant <jats:italic>Staphylococcus<\/jats:italic> colonization (aOR, 9.56; 95% CI, 1.55\u201327.77). Clinically effective prevention interventions included preprocedural skin cleaning with chlorhexidine versus other topical agents (aOR, 0.41; 95% CI, 0.22\u20130.76) and receipt of \u03b2-lactam antimicrobial prophylaxis versus vancomycin (aOR, 0.60; 95% CI, 0.37\u20130.96). The use of mesh pockets and continuation of antimicrobial prophylaxis after skin closure were not associated with reduced infection risk.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19001272_as7\"><jats:title>Conclusions:<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2019.127","type":"journal-article","created":{"date-parts":[[2019,6,4]],"date-time":"2019-06-04T08:32:59Z","timestamp":1559637179000},"page":"855-862","source":"Crossref","is-referenced-by-count":24,"title":["Real-world effectiveness of infection prevention interventions for reducing procedure-related cardiac device infections: Insights from the veterans affairs clinical assessment reporting and tracking program"],"prefix":"10.1017","volume":"40","author":[{"given":"Archana","family":"Asundi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maggie","family":"Stanislawski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Payal","family":"Mehta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna E.","family":"Baron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hillary J.","family":"Mull","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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