{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T16:00:10Z","timestamp":1774627210548,"version":"3.50.1"},"reference-count":69,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The National Recovery and Resilience Plan","award":["2024\/ABM\/03\/KPO\/KPOD.07.07-IW.07-0004\/24-00"],"award-info":[{"award-number":["2024\/ABM\/03\/KPO\/KPOD.07.07-IW.07-0004\/24-00"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Introduction: Bacterial multidrug resistance (MDR) drives treatment with expensive, toxic, or pharmacokinetically suboptimal antibiotics. Objectives: To assess the prevalence of MDR Gram-positive cocci among isolates from cardiac implantable electronic device (CIED) infections at a Polish reference center. Methods: Data come from the \u201cEXTRACT\u201d registry (ClinicalTrials.gov ID NCT05775783), which covers 702 transvenous lead extraction procedures. Blood samples and intraoperative swabs were collected from participants with CIED infection. Results: From 209 cases with isolated pocket infection (PI) (107, 51.2%) or systemic infections (102, 48.8%), 263 Gram-positive cocci were cultured. They were: coagulase-negative staphylococci (CoNS) (177, 67.3%), Staphylococcus aureus (62, 23.6%), enterococci (15, 5.7%), streptococci (8, 3.0%), and others (1, 0.4%). The highest MDR rate was among CoNS (46.9%). CoNS exhibited methicillin resistance (MR-CoNS) in 55.9% with co-resistance to macrolides (73.2%), lincosamides (51.0%), fluoroquinolones (56.1%), aminoglycosides (41.4%), tetracyclines (29.6%), and co-trimoxazole (29.3%). Resistance to daptomycin (5.3%) and linezolid (2.0%) in MR-CoNS was rare. The frequency of MDR S. aureus was 8.1%. Methicillin resistance in S. aureus (MRSA, 6.5%) co-occurred with resistance to macrolides\/lincosamides and fluoroquinolones (100% for both) or linezolid (25.0%). All MDR staphylococci were vancomycin-susceptible. High-level aminoglycoside resistance (HLAR) in Enterococcus faecalis (53.8%) was accompanied by levofloxacin co-resistance (66.7%). Conversely, E. faecium HLAR (50.0%) strains showed 100.0% \u03b2-lactam resistance. Vancomycin-resistant enterococci (VRE) accounted for 6.7%; the VRE E. faecium strain was tigecycline- and linezolid-susceptible. Among viridans group streptococci, \u03b2-lactam and lincosamides resistance was common (40.0% for both), with 50.0% of co-resistance. Conclusions: Epidemiological data may improve the effectiveness of empirical antibiotic therapy for CIED-related infections.<\/jats:p>","DOI":"10.3390\/antibiotics15040345","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T14:33:33Z","timestamp":1774622013000},"page":"345","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Drug-Resistant Gram-Positive Cocci as Etiological Factors of Cardiac Implantable Electronic Device Infections\u2014Data from the EXTRACT Registry"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2932-6269","authenticated-orcid":false,"given":"Danuta","family":"\u0141oboda","sequence":"first","affiliation":[{"name":"Department of Electrocardiology and Heart Failure, Medical University of Silesia, 40-635 Katowice, Poland"},{"name":"Department of Electrocardiology, Upper-Silesian Medical Centre in Katowice, 40-635 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8770-8321","authenticated-orcid":false,"given":"Sylwia","family":"G\u0142adysz-Wa\u0144ha","sequence":"additional","affiliation":[{"name":"Department of Electrocardiology, Upper-Silesian Medical Centre in Katowice, 40-635 Katowice, Poland"},{"name":"Doctoral School, Medical University of Silesia, 40-055 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0562-9695","authenticated-orcid":false,"given":"Micha\u0142","family":"Joniec","sequence":"additional","affiliation":[{"name":"Department of Electrocardiology, Upper-Silesian Medical Centre in Katowice, 40-635 Katowice, Poland"},{"name":"Doctoral School, Medical University of Silesia, 40-055 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugeniusz","family":"Pi\u0142at","sequence":"additional","affiliation":[{"name":"Department of Electrocardiology, Upper-Silesian Medical Centre in Katowice, 40-635 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0334-0938","authenticated-orcid":false,"given":"Robert D.","family":"Wojtyczka","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, 41-200 Sosnowiec, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0002-8591","authenticated-orcid":false,"given":"Beata","family":"Sarecka-Hujar","sequence":"additional","affiliation":[{"name":"Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, 41-200 Sosnowiec, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Staro\u0144","sequence":"additional","affiliation":[{"name":"Department of Electrocardiology, Upper-Silesian Medical Centre in Katowice, 40-635 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5508-7567","authenticated-orcid":false,"given":"Denis","family":"Swolana","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, 41-200 Sosnowiec, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Micha\u0142","family":"Gibi\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Electrocardiology and Heart Failure, Medical University of Silesia, 40-635 Katowice, Poland"},{"name":"Department of Electrocardiology, Upper-Silesian Medical Centre in Katowice, 40-635 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karolina","family":"Simionescu","sequence":"additional","affiliation":[{"name":"Department of Electrocardiology and Heart Failure, Medical University of Silesia, 40-635 Katowice, Poland"},{"name":"Department of Electrocardiology, Upper-Silesian Medical Centre in Katowice, 40-635 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6066-3127","authenticated-orcid":false,"given":"S\u0142awomir","family":"Wilczy\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, 41-200 Sosnowiec, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5722-7976","authenticated-orcid":false,"given":"Krzysztof S.","family":"Go\u0142ba","sequence":"additional","affiliation":[{"name":"Department of Electrocardiology and Heart Failure, Medical University of Silesia, 40-635 Katowice, Poland"},{"name":"Department of Electrocardiology, Upper-Silesian Medical Centre in Katowice, 40-635 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"ref_1","unstructured":"(2026, January 08). 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