Contamination of Transvenous Pacemaker Leads Due to Tunneled Hemodialysis Catheter Infection: A Report of 2 Cases

Roger G. Carrillo, Juan D. Garisto, Loay Salman, Donna Merrill, Arif Asif

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Catheter-related bacteremia is a frequent complication associated with the use of tunneled hemodialysis catheters. Catheter-related bacteremia can lead to metastasis of infection to other sites. This article presents 2 patients with transvenous pacemakers (placed >2 years ago) who were receiving long-term hemodialysis therapy using tunneled hemodialysis catheters. Both were admitted to the hospital with catheter-related bacteremia. Blood cultures showed methicillin-resistant Staphylococcus aureus (MRSA) in both cases. Transesophageal echocardiography was negative for the presence of valvular endocarditis, but showed lead-associated vegetation in both cases. Intravenous antibiotic therapy was initiated, and both the tunneled hemodialysis catheters and cardiac devices were removed by a cardiothoracic surgeon. The catheter tip and leads cultures showed MRSA in both cases. After resolution of bacteremia, both patients received an epicardial cardiac device. Antibiotic therapy was continued for 6 weeks. Renal physicians providing dialysis therapy should be aware that catheter-related bacteremia could cause contamination of transvenous pacemaker leads. Because catheter-related bacteremia is a frequent complication, epicardial leads might be considered as an alternative route to provide cardiac support to catheter-consigned patients. Epicardial leads do not navigate through the central veins, lie in the path of blood flow, or cause central venous stenosis.

Original languageEnglish (US)
Pages (from-to)1097-1101
Number of pages5
JournalAmerican Journal of Kidney Diseases
Volume55
Issue number6
DOIs
StatePublished - Jun 1 2010

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Keywords

  • catheter-related bacteremia
  • Hemodialysis
  • pacemaker
  • tunneled dialysis catheter

ASJC Scopus subject areas

  • Nephrology

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