Boston Scientific Corp: Consultant, Speaker honorarium. Spectranetics: Consultant, Speaker honorarium. Medtronic Inc.: Consultant, Speaker honorarium. Medtronic Inc.: Investigator, Research support. Sohail, TyRx Inc.: Investigator, Research support. Peacock Jr., Pfizer, Inc.: Shareholder, Owns common stock in Pfizer which was inherited and held in a trust.

At 6 months follow-up, no relapses had occurred but overall mortality was 24%. Only 67% of patients underwent device removal. A penicillin plus aminoglycoside, given for 6 weeks, was the most frequent therapy. IE was the most common infectious syndrome. Most infections appeared to be hematogenous in origin with late onset.

Conclusion Enterococci caused 4.8% of all CIED infections in our cohort. There was one death during the index hospital stay with four additional patients dying over the 6 months after therapy (overall mortality 24%) two of the seven patients retaining their CIED died. Only 14 patients (67%) had complete device removal the seven patients retaining their device were judged to be at high risk for extraction. Antibiotics were given for a median of 43 days. The most common antimicrobial regimen was a penicillin plus aminoglycoside (38%) two patients (9.5%) received ampicillin + ceftriaxone. Blood cultures grew enterococci from all patients. All 21 patients underwent TEE with vegetations demonstrated in 17 (81%). The most common presenting symptom was fever (48%) five patients (24%) exhibited local signs of pocket infection. Median time from last device procedure to infection was 510 days (range 37–2,952 days). Fourteen cases of IE (78%) were definite by the modified Duke criteria. Of the IE cases, four were valvular IE, eight were lead IE, and six were both. Among the 21 infections, 3 (14%) were categorized as CIED-related bloodstream infections and 18 (86%) as IE no patient had isolated pocket infection. Twelve patients (57%) had permanent pacemakers, 5 (24%) had implantable cardioverter defibrillators, and 4 (19%) had biventricular devices. Specific data on enterococcal species and antimicrobial susceptibilities were not recorded. Results Of 433 patients, 21 (4.8%) were diagnosed with enterococcal CIED infection. Methods Data from the Multicenter Electrophysiologic Device Infection Collaboration (MEDIC), a prospective, observational, multinational cohort study of CIED infections, were used to provide a descriptive analysis of adult patients with CIED infections due to enterococcal species. Abstract Background Unlike enterococcal native and prosthetic valve infective endocarditis (IE), enterococcal CIED infections are not well described.

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