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Hemodialysis catheter infections

Clara K Poon, Christopher T Chan
Home hemodialysis (HHD) is emerging as an important alternate renal replacement therapy. Although there are multiple clinical advantages with HHD, concerns surrounding increased risks of infection in this group of patients remain a major barrier to its implementation. In contrast to conventional hemodialysis, infection related complication represents the major morbidity in this mode of renal replacement therapy. Vascular access related infection is an important cause of infection in this population. Use of central vein catheters and buttonhole cannulation in HHD are important modifiable risk factors for HHD associated infection...
October 25, 2016: Hemodialysis International
Masaaki Murakami, Genichi Sakaguchi, Noriko Mori
OBJECTIVE: In patients with a high risk of fistula immaturity, we created arteriovenous fistulas (AVFs) combined with brachial artery superficialization. With this procedure, the superficialized arteries are used as drawing routes and the AVFs as returning routes. This is a technical report about AVFs combined with brachial artery superficialization. METHODS: Twenty-four consecutive patients with a high risk of fistula immaturity who underwent AVFs with brachial artery superficialization were included in this single-center retrospective study...
October 12, 2016: Journal of Vascular Surgery
Talerngsak Kanjanabuch, Nuttha Lumlertgul, Lachlan J Pearson, Tanittha Chatsuwan, Krit Pongpirul, Asada Leelahavanichkul, Nisa Thongbor, Gunticha Nuntawong, Laksamon Praderm, Pantiwa Wechagama, Surapong Narenpitak, Apinya Wechpradit, Worauma Punya, Guttiga Halue, Phetpailin Naka, Somboon Jeenapongsa, Somchai Eiam-Ong
♦ Background: Melioidosis, an infectious disease caused by Burkholderia pseudomallei, is endemic in Southeast Asia and Northern Australia. Although a wide range of clinical manifestations from this organism are known, peritonitis associated with peritoneal dialysis (PD) has rarely been reported. ♦ Patients and Methods: Peritoneal dialysis patients from all regions in Thailand were eligible for the study if they had peritonitis and either peritoneal fluid or effluent culture positive for B.pseudomallei Patient data obtained included baseline characteristics, laboratory investigations, treatments, and clinical outcomes...
October 13, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Soo Jin Park, Ji Ye Park, Joonho Jung, You Sun Hong, Cheol Joo Lee, Sang Hyun Lim
The dehiscence of saphenous vein grafts (SVGs) is a rare, often fatal, complication of coronary artery bypass grafting (CABG). We present the case of a 57-year-old man who underwent hemiarch graft interposition and CABG for a Stanford type A aortic dissection. Five months after discharge, the patient developed streptococcal sepsis caused by a hemodialysis catheter. Complete rupture of the proximal anastomoses of the saphenous veins and containment by the obliterated pericardial cavity was observed 25 months after the initial operation...
October 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Lihua Wang, Fang Wei, Haiyan Chen, Guijiang Sun, Haibo Yu, Aili Jiang
PURPOSE: For patients who rely on a tunneled cuffed catheter, replacement or catheter removal is typically necessary. We recently performed a modified de novo insertion technique for catheter replacement in our practice. As the technique has not yet been studied comprehensively, we performed a retrospective study to evaluate the safety and efficacy of de novo placed catheter without delay for catheter replacement in elderly hemodialysis patients. METHODS: A retrospective review of 164 elderly patients was conducted during a period of three years...
September 27, 2016: Journal of Vascular Access
Carlos A Hinojosa, Javier E Anaya-Ayala, Alejandra Lopez-Mendez, Zeniff Gomez-Arcive, Hugo Laparra-Escareno, Cesar Cuen-Ojeda, Rene Lizola, Adriana Torres-Machorro
Exhaustion of superficial veins coupled with the presence of intrathoracic central venous occlusions remains a significant obstacle for hemodialysis access creation; complex arteriovenous graft (AVG) configurations have been described. The axillary-iliac AVG was first reported in 1987, and few authors have explored this access. We evaluated our experience with this AVG configuration utilizing the early cannulation (EC) graft Flixene™ (Atrium ™, Hudson, NH, USA). Eight patients (75 % men; mean age 37 ± 10 years) with End-Stage Renal Disease (ESRD) underwent axillo-iliac AVG creation with Flixene™ grafts; all had exhausted peripheral veins, occluded thoracic central veins, and inadequate femoral veins...
October 5, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Andrew S Griffin, Shawn M Gage, Jeffrey H Lawson, Charles Y Kim
OBJECTIVE: This study evaluated whether the use of a staged Hemodialysis Reliable Outflow (HeRO; Merit Medical, South Jordan, Utah) implantation strategy incurs increased early infection risk compared with conventional primary HeRO implantation. METHODS: A retrospective review was performed of 192 hemodialysis patients who underwent HeRO graft implantation: 105 patients underwent primary HeRO implantation in the operating room, and 87 underwent a staged implantation where a previously inserted tunneled central venous catheter was used for guidewire access for the venous outflow component...
September 26, 2016: Journal of Vascular Surgery
Lynda K Ball, Cheryl A George, Linda Duval, Niloufar Nellie F Hedrick
Introduction Infection in our immunocompromised patients is the second leading cause of death, according to the Centers for Disease Control and Prevention (CDC). In an effort to improve quality of care, engage patients in their own care, and reduce morbidity and mortality secondary to infection, the Network designed a joint quality improvement/patient engagement activity to decrease bloodstream infection (BSI) rates. Methods Dialysis facilities were ranked utilizing 2014 National Healthcare Safety Network (NHSN) data...
October 2016: Hemodialysis International
Aisha Khattak, Ernest I Mandel, Matthew R Reynolds, David M Charytan
BACKGROUND: Percutaneous coronary intervention (PCI) use is low in the setting of stable symptomatic angina in individuals with advanced chronic kidney disease (CKD) despite high cardiovascular risk in this population, and PCI is frequently deferred out of concern for precipitating dialysis therapy. Whether this is appropriate is uncertain, and patient-centered data comparing the relative risks and benefits of continued medical therapy versus PCI in patients with advanced CKD and stable angina are scarce...
September 16, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Jesmar Buttigieg, Angela Borg Cauchi, Marilyn Rogers, Emanuel Farrugia, Stephen Fava
Seasonal variation in the incidence of peritoneal dialysis-related infections (PDRI) has been sparingly investigated, especially in the Mediterranean. Our aim was to explore this association in Malta. All PDRI occurring between Jan-2008 and Dec-2012 were retrospectively studied.A total of 137 patients were followed-up for a median time of 32.5 months (range: 2-81). During this time, 19% never had PDRI, 11.7% transferred permanently to hemodialysis and 6.6% received a kidney transplant. A total of 279 PDRI were identified, equating to 145 catheter-related infections (CRI) and 144 peritonitis episodes (including 10 catheter related peritonitis)...
October 2016: Therapeutic Apheresis and Dialysis
Bekir Şanal, Ömer Fatih Nas, Nurullah Doğan, Mehmet Korkmaz, Kadir Hacıkurt, Abdulmecid Yıldız, İrem İris Kan Aytaç, Bahattin Hakyemez, Cüneyt Erdoğan
PURPOSE: We aimed to investigate the safety and functionality of tunneled transhepatic hemodialysis catheters in chronic hemodialysis patients. METHODS: Thirty-eight patients (20 women aged 56±10 years and 18 men aged 61±11 years) with transhepatic tunneled hemodialysis catheters were evaluated. The date of the first transhepatic catheterization, indications, procedure details, functional time periods of catheters, reasons for the removal or revision of catheters, catheter-related complications, and current conditions of patients were retrospectively analyzed...
September 6, 2016: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
W K Wong, T-W Su, W-L Cheng, H-T Yang, W-C Wei, P-J Ko
OBJECTIVE/BACKGROUND: Pseudoaneurysm formation occurs in 2-10% of hemodialysis arteriovenous grafts (AVGs). Surgical repair often requires pseudoaneurysm resection, interposition graft placement, and insertion of a catheter as a bridge. Endovascular stent graft repair is a controversial alternative therapy. This study was performed to examine the effectiveness and mid-term outcomes of stent graft repair for AVG pseudoaneurysms. METHODS: All patients who had undergone stent graft repair for AVG pseudoaneurysms between December 2012 and July 2015 were identified from hospital medical records for retrospective analysis...
September 1, 2016: European Journal of Vascular and Endovascular Surgery
Franklin Correa Barcellos, Bruno Pereira Nunes, Luciana Jorge Valle, Thiago Lopes, Bianca Orlando, Cintia Scherer, Marcia Nunes, Gabriela Araújo Duarte, Maristela Böhlke
BACKGROUND: Central venous catheters (CVC) are the only option when hemodialysis is needed for patients without definitive vascular access. However, CVC is associated with complications, such as infection, thrombosis, and dysfunction, leading to higher mortality and expenditures. The aim of this study was to compare the effectiveness of 30 % trisodium citrate (TSC30 %) with heparin as CVC lock solutions in preventing catheter-related bloodstream infections (CRBSI) and dysfunction in hemodialysis patients...
August 29, 2016: Infection
Aya Imafuku, Naoki Sawa, Yoshifumi Ubara, Kenmei Takaichi
Acquired hemophilia A (AHA) is a rare bleeding disorder caused by autoantibodies to coagulation factor VIII (FVIII). AHA onset during the induction of dialysis is extremely rare, and the management of blood access is difficult. We present a case of AHA that developed during induction of dialysis and treatment with double filtration plasmapheresis (DFPP). An 86-year-old man with chronic kidney disease was admitted to our hospital with multiple subcutaneous hemorrhages. Because of his prolonged activated partial thromboplastin time (aPTT) and high titer of inhibitors to FVIII, he was diagnosed with AHA, and prednisolone treatment was started...
August 22, 2016: Clinical Nephrology
Manouchehr Amini
The study aimed to compare the rates of central line-associated bloodstream infection (CLABSI) for all hemodialysis patients with a central catheter across the majority of Shariati hospital wards during a 6-month, 2-phase, before-and-after intervention. The median rate of CLABSI decreased from 18.1% at baseline to 6.5% after implementation of the intervention (64% reduction in CLABSI rate) (P = .002). The data analysis indicated that providing intensive training can positively influence the control of CLABSI in large teaching hospitals...
August 17, 2016: American Journal of Infection Control
Marco Righetti, Nicola Palmieri, Oscar Bracchi, Mario Prencipe, Elena Bruschetta, Francesca Colombo, Irene Brenna, Francesca Stefani, Karen Amar, Alfio Scalia, Ferruccio Conte
INTRODUCTION: Catheter-related infections are an important clinical problem in maintenance hemodialysis patients. Catheter-related bloodstream infections have a negative effect on survival, hospitalization and cost of care. Tegaderm™ chlorhexidine gluconate (CHG) dressing may be useful to reduce catheter-related infection rates. METHODS: We performed a study to assess the efficacy of Tegaderm™ CHG dressing for reducing catheter-related infections. We designed a prospective randomized cross-over study with a scheme of two treatments, Tegaderm™ CHG dressing versus standard dressing, and two periods of six months...
August 1, 2016: Journal of Vascular Access
S Balakrishnan, A Aamar, S Rhee, S Zakaria, W Khaliq
Gram-negative endocarditis is rare and it has high mortality if there is a delay in diagnosis and treatment. Gram-negative organisms should be considered in the differential diagnosis of IE in hemodialysis patients. Central lineassociated bloodstream infections (CLABSIs) can be prevented by following sterile measures during catheter insertion and proper management of catheter site.
June 2016: Medical Journal of Malaysia
Mariana Brandão, Jorge Almeida, Rita Ferraz, Lurdes Santos, Paulo Pinho, Jorge Casanova
Fungal prosthetic valve endocarditis is an extremely severe form of infective endocarditis, with poor prognosis and high mortality despite treatment. Candida albicans is the most common etiological agent for this rare but increasingly frequent condition. We present a case of fungal prosthetic valve endocarditis due to C. albicans following aortic and pulmonary valve replacement in a 38-year-old woman with a history of surgically corrected tetralogy of Fallot, prior infective endocarditis and acute renal failure with need for catheter-based hemodialysis...
September 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Jingjing Zhang, Renee A Burr, Heena S Sheth, Beth Piraino
BACKGROUND: Data on hemodialysis (HD)-related organism specific bacteremia rates by type of access over an extended period are scant in the literature. Using a registry data base we examined all positive blood cultures by organisms for each type of HD access over 14 years. METHODS: The IRB-approved registry data collection of prevalent patients at our HD unit from 1/1/1999 through 12/31/2012 was analyzed. All positive blood cultures were recorded and expressed as episodes/1,000 days by access type: arteriovenous fistula (AVF), arteriovenous graft (AVG), and central venous catheter (CVC)...
September 2016: Clinical Nephrology
Farida Sahli, Razika Feidjel, Rima Laalaoui
The main complication of central venous catheter (CVC) in hemodialysis is infection. Identifying CVC related infection (CVC-RI) risk factors and causative micro-organisms is important for setting prevention policies. There were no data regarding CVC-RI in hemodialysis in Algeria. To determine rates of CVC-RI in hemodialysis in Setif university hospital, risk factors and causative microorganisms, we conducted a prospective study from November 2014 to May 2015 involving patients with CVC in hemodialysis. Micro-organisms isolated from semi quantitative culture of CVC and blood culture were identified and tested for antibiotic susceptibility using the automated MicroScan system (DADE Behring, Sacramento, CA, USA)...
July 13, 2016: Journal of Infection and Public Health
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