Abstract

Infections related to cardiac implantable electronic devices present a significant challenge for specialists and often necessitate the removal of these devices. Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most common culprits behind these infections. When MRSA bacteremia occurs in conjunction with a cardiac device infection, imaging studies may not always confirm the involvement of the device. However, it is common practice to remove the entire device to effectively control the source of the infection. Patients may require long courses of antibiotic therapy, and sometimes a combination of two or more antibiotics is necessary to clear the associated bacteremia. Prophylactic treatment for presumptive endocarditis is frequently employed to prevent the infection from spreading to other parts of the body. Recurrence or persistence of MRSA bacteremia often mandates the removal of the cardiac device, raising concerns about the patient’s reliance on the device. This manuscript aims to provide a comprehensive overview of the challenges in managing MRSA bacteremia in patients with cardiac devices, highlighting the complexities of diagnosis, treatment options, and the critical decisions surrounding device management.

Keywords

MRSA, implantable cardiac devices, bacteremia, biofilm, antibiotic therapy, infective endocarditis.