Pacemaker infections: a 12-year review.

In a 12-year period, 546 pacemaker-related operations were complicated by 23 infections (infection rate, 4.2%). Most of these infections were treated successfully, but two cases of infection were fatal. The most frequently encountered organism was Staphylococcus epidermidis. In 14 cases, infection occurred despite the preoperative administration of cloxacillin to which the organism was sensitive in 13 of the cases. The skin flora constitute the most likely source of contamination. The ideal treatment consists of removal of all foreign material and replacement with a new pacing system by an alternative route.