Detailed bacteriologic tests to identify the origin of transvenous pacing system infections indicate a high prevalence of multiple organisms

(1) Regardless of the clinical presentation, the extravascular and intravascular body of the lead is infected, even when the infection is local. More than one microorganism may be implicated. (2) Bacteriologic analyses must be performed on several segments of each implanted lead. (3) More than 2 positive blood cultures are a reliable clinical criterion for the diagnosis of pacemaker lead-related infection, but blood cultures alone are an insensitive method to identify the cause of infection. (4) Up to 50% of microorganisms isolated in a single blood culture are also recovered in lead cultures.