Researchers tackling surveillance of infection after cardiac implantable electronic device implantation

Cardiac implantable electronic devices (CIED), such as pacemakers, can be lifesaving, but complex infections following surgical implantation of a device can be serious and even deadly. Although rare, typically occurring in between one and four per cent of surgeries, these infections are devastating for patients and put pressure on the health care system.

Monitoring and tracking these infections is critical for prevention, but a comprehensive surveillance program requires Infection Prevention and Control (IPC) experts to comb through patient charts and test results looking for possible infections, which is time consuming and costly for the medical system.

Dr. Elissa Rennert-May, MD, a local infectious diseases physician, says although Calgary has implemented a gold standard of infection surveillance for patients who have undergone CIED surgery, the cost of implementing such a program is prohibitive for most centres in Canada.

“Because the process of monitoring and reporting CIED infections is so labour intensive, most sites aren’t able to implement them,” she says, adding there is no national-wide strategy for comprehensive monitoring and reporting of infection following CIED surgery.

Dr. Jenine Leal, PhD, a research scientist working in Infection Prevention and Control, partnered with Rennert-May and cardiologist and researcher Dr. Derek Chew, MD, to tackle the problem of a lack of surveillance across the country.

She explains the trio developed an algorithm that uses data collected through electronic patient records and administrative data to identify CIED infections. She’s optimistic about the potential, noting although their solution won’t meet the gold standard of a comprehensive IPC surveillance program, it will go a long way towards filling the gap.

Like Leal, Chew is also excited about the algorithm’s potential to improve patient outcomes while using fewer resources.

“We asked how we can do effective surveillance on a national level for a reasonable cost,” says Chew. “Looking at patient data that is already collected can help track these infections and identify any potential sites that are experiencing higher than normal infection rates.”

Chew, Rennert-May and Leal recently received a Canadian Institutes for Health Research grant to pilot their algorithm across Alberta. Their goal is to validate its effectiveness and ability to improve patient experience. In the future they hope to implement their innovative solution for CIED infection surveillance across Canada.

Dr. Derek Chew, MD, MSc, is an assistant professor in the departments of Cardiac Sciences, Medicine and Community Health Sciences at the Cumming School of Medicine (CSM). He is a member of the CSM’s Libin Cardiovascular Institute and the O’Brien Institute for Public Health.

Dr. Elissa Rennert-May, MD, MSc, is an assistant professor in the Departments of Medicine, Community Health Sciences, and Microbiology, Immunology and Infectious Diseases at the Cumming School of Medicine. She is a member of the O’Brien Institute for Public Health and the Snyder Institute for Chronic Diseases.

Dr. Jenine Leal, PhD, is the Infection Prevention and Control Research Scientist in Alberta Health Services and an assistant professor in the Departments of Community Health Sciences and Microbiology, Immunology & Infectious Diseases. She is a member of the O’Brien Institute for Public Health.