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Hemodialysis catheter infections

Mariusz Kusztal, Krzysztof Nowak
For arrhythmia treatment or sudden cardiac death prevention in hemodialysis patients, there is a frequent need for placement of a cardiac implantable electronic device (pacemaker, implantable cardioverter defibrillator, or cardiac resynchronization device). Leads from a cardiac implantable electronic device can cause central vein stenosis and carry the risk of tricuspid regurgitation or contribute to infective endocarditis. In patients with end-stage kidney disease requiring vascular access and cardiac implantable electronic device, the best strategy is to create an arteriovenous fistula on the contralateral upper limb for a cardiac implantable electronic device and avoidance of central vein catheter...
March 1, 2018: Journal of Vascular Access
Salvatore Mandolfo, Milena Maggio, Chiara Ronga, Adriano Anesi, Vanina Rognoni
No abstract text is available yet for this article.
March 1, 2018: Journal of Vascular Access
Hirotake Kasuga
Most of the peritoneal dialysis patients stop their peritoneal dialysis therapy and transfer to hemodialysis or kidney transplantation. In Japan, most end-stage kidney disease patients select hemodialysis after peritoneal dialysis discontinuation. Peritoneal dialysis catheter will be removed after stopping peritoneal dialysis. If peritoneal dialysis patients suffer from refractory peritonitis or severe tunnel infection, we remove the peritoneal dialysis catheter immediately. However, the causes of peritoneal dialysis discontinuation are ultrafiltration failure or peritoneal membrane dysfunction, and we have to consider the timing of peritoneal dialysis catheter removal...
March 1, 2018: Journal of Vascular Access
Hoon Suk Park, Joonsung Choi, Hyung Wook Kim, Jun Hyun Baik, Cheol Whee Park, Young Ok Kim, Chul Woo Yang, Dong Chan Jin
PURPOSE: The exchange from a non-tunneled hemodialysis catheter to a tunneled one over a guidewire using a previous venotomy has been reported to be safe. However, some concerns that it may increase infection risk prevent its clinical application. This approach seems particularly useful for acute kidney injury patients requiring initial renal replacement therapy, in whom we frequently worry about the choice of non-tunneled versus tunneled catheters. MATERIALS AND METHODS: From March 2012 to February 2016, 88 cases to receive the over-the-guidewire exchange method from a non-tunneled to a tunneled catheter and 521 cases to receive de novo tunneled catheter placement from the hemodialysis vascular access cohort were compared retrospectively...
March 1, 2018: Journal of Vascular Access
Mauro Sergio Martins Marrocos, Thais Marques S Gentil, Fernanda de C Lima, Sandra Maria R Laranja
PURPOSE: Real-time ultrasound is indicated for hemodialysis catheters' insertion in internal jugular veins. We evaluated unsuccessful implantation of short-term hemodialysis catheters in internal jugular veins using real-time ultrasound between patients with and without previous short-term catheters. METHODS: Observational open-label study of unsuccessful implantation of short-term hemodialysis catheters in internal jugular veins using real-time ultrasound from July 2013 to August 2014...
March 1, 2018: Journal of Vascular Access
V Hoerr, M Franz, M W Pletz, M Diab, S Niemann, C Faber, T Doenst, P C Schulze, S Deinhardt-Emmer, B Löffler
Infective endocarditis (IE) is a life-threatening disease, caused by septic vegetations and inflammatory foci on the surface of the endothelium and the valves. Due to its complex and often indecisive presentation the mortality rate is still about 30%. Most frequently bacterial microorganisms entering the bloodstream are the underlying origin of the intracardiac infection. While the disease was primarily restricted to younger patients suffering from rheumatic heart streptococci infections, new at risk categories for Staphylococcus (S...
February 21, 2018: International Journal of Medical Microbiology: IJMM
Kelly A Lara, Rochelle Anne Chua, Trung D Vo
Autogenous arteriovenous fistula (AVF) is the primary recommended access for hemodialysis. Long term use will not uncommonly result in AVF aneurysmal degeneration. Aneurysm associated complications encompass pain, skin ulceration, infection, thrombosis, cannulation difficulties, and life-threatening bleeding. Various methods to repair aneurysmal AVFs have been described. However, there may be circumstances when this is not possible, and require insertion of a temporary hemodialysis catheter (HDC) until a new arteriovenous access is created...
February 23, 2018: Annals of Vascular Surgery
Tracy N Zembles, Linda S Flannery, Anna R Huppler
PURPOSE: The development and implementation of an antimicrobial lock therapy guideline at a large pediatric hospital are described. SUMMARY: Central venous access devices (CVADs) are essential in the medical management of patients requiring long-term total parenteral nutrition, chemotherapy, or hemodialysis. However, the use of a CVAD carries a significant risk of the development of central line-associated bloodstream infection (CLABSI). Antimicrobial lock therapy is indicated for patients with CLABSIs who have no signs of exit site or tunnel infection and for whom catheter salvage is a goal...
March 1, 2018: American Journal of Health-system Pharmacy: AJHP
Steven M Brunelli, David B Van Wyck, Levi Njord, Robert J Ziebol, Laurie E Lynch, Douglas P Killion
Central venous catheters (CVCs) contribute disproportionately to bloodstream infection (BSI) and, by extension, to infection-related hospitalization, mortality, and health care costs in patients undergoing dialysis. Recent product advancements may reduce BSIs, but a sufficiently powered comparative-effectiveness study is needed to facilitate evidence-based patient care decisions. In a 13-month, prospective, cluster-randomized, open-label trial, we compared BSI rates in facilities using ClearGuard HD antimicrobial barrier caps (ClearGuard group) with those in facilities using Tego hemodialysis connectors plus Curos disinfecting caps (Tego+Curos group)...
February 22, 2018: Journal of the American Society of Nephrology: JASN
Fernando Chaves, José Garnacho-Montero, José Luis Del Pozo, Emilio Bouza, José Antonio Capdevila, Marina de Cueto, M Ángeles Domínguez, Jaime Esteban, Nuria Fernández-Hidalgo, Marta Fernández Sampedro, Jesús Fortún, María Guembe, Leonardo Lorente, Jose Ramón Paño, Paula Ramírez, Miguel Salavert, Miguel Sánchez, Jordi Vallés
Catheter-related bloodstream infections (CRBSI) constitute an important cause of hospital-acquired infection associated with morbidity, mortality, and cost. The aim of these guidelines is to provide updated recommendations for the diagnosis and management of CRBSI in adults. Prevention of CRBSI is excluded. Experts in the field were designated by the two participating Societies (Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica and the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias)...
February 2018: Enfermedades Infecciosas y Microbiología Clínica
F Chaves, J Garnacho-Montero, J L Del Pozo, E Bouza, J A Capdevila, M de Cueto, M Á Domínguez, J Esteban, N Fernández-Hidalgo, M Fernández Sampedro, J Fortún, M Guembe, L Lorente, J R Paño, P Ramírez, M Salavert, M Sánchez, J Vallés
Catheter-related bloodstream infections (CRBSI) constitute an important cause of hospital-acquired infection associated with morbidity, mortality, and cost. The aim of these guidelines is to provide updated recommendations for the diagnosis and management of CRBSI in adults. Prevention of CRBSI is excluded. Experts in the field were designated by the two participating Societies (the Spanish Society of Infectious Diseases and Clinical Microbiology and [SEIMC] and the Spanish Society of Spanish Society of Intensive and Critical Care Medicine and Coronary Units [SEMICYUC])...
January 2018: Medicina Intensiva
Venkatesh Thammishetti, Anupama Kaul, Dharmendra S Bhadauria, Karthikeyan Balasubramanian, Narayan Prasad, Amit Gupta, Raj K Sharma
BACKGROUND: Refractory peritonitis is defined as failure of clearance of peritoneal fluid despite 5 days of appropriate antibiotic therapy. Catheter removal decreases morbidity and mortality. Data on the outcomes of refractory peritonitis and of reinitiation of peritoneal dialysis (PD) in this group of patients are sparse. The present study analyzed etiology, outcomes, and prognostic factors of refractory peritonitis as well as survival of the reinitiation of the technique. METHODS: This was a single-center retrospective study that included 90 patients of refractory continuous ambulatory PD (CAPD) peritonitis at a tertiary care center in North India...
January 31, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Jorinde H van Laanen, Tom Cornelis, Barend M Mees, Elisabeth Litjens, Magda M van Loon, Jan H Tordoir, Arnoud G Peppelenbosch
OBJECTIVE: To determine the best operation technique, open versus laparoscopic, for insertion of a peritoneal dialysis (PD) catheter with regard to clinical success. Clinical success was defined as an adequate function of the catheter 2 - 4 weeks after insertion. METHODS: All patients with end-stage renal disease who were suitable for PD and gave informed consent were randomized for either open surgery or laparoscopic surgery. A previous laparotomy was not considered an exclusion criterion...
January 31, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Januvi Jegatheswaran, Jeffrey Warren, Deborah Zimmerman
Patients treated with peritoneal dialysis (PD) are often required to switch to hemodialysis (HD) temporarily when they develop abdominal wall hernias and dialysate leaks, peritonitis or undergo thoracic or abdominal surgeries. There are significant risks associated with incident hemodialysis including possible central venous catheter infections, thrombosis, and need for invasive procedures. Therefore, strategies to avoid temporary transfer to hemodialysis are desirable. The increased intra-abdominal pressure associated with PD is largely responsible for the issues requiring withholding PD...
January 30, 2018: Seminars in Dialysis
Mayra Gonçalves Menegueti, Natália Cristina Betoni, Fernando Bellissimo-Rodrigues, Elen Almeida Romão
INTRODUCTION: Bloodstream infections are the second most common cause of death among patients on hemodialysis. This study aimed to evaluate the incidence of and risk factors associated with central venous catheter-related infections in patients undergoing hemodialysis, and to identify and characterize the type and antimicrobial susceptibility profiles of the primary microorganisms isolated during one year of follow-up. METHODS: A prospective cohort study was conducted in 2014 in a hemodialysis referral center...
November 2017: Revista da Sociedade Brasileira de Medicina Tropical
Frédéric Franconieri, Julie Bonhomme, Aline Doriot, Cécile Bonnamy, Maxence Ficheux, Thierry Lobbedez, Clémence Béchade
Rhodotorula mucilaginosa is a ubiquitous yeast that may cause serious peritoneal dialysis (PD) infections. A 70-year-old man receiving continuous ambulatory peritoneal dialysis (CAPD) for 6 months presented with a PD infection caused by Rhodotorula mucilaginosa The patient was treated with intravenous liposomal amphotericin B. His peritoneal catheter was simultaneously removed and reinserted. To date, only 10 cases of Rhodotorula CAPD infections have been reported. Catheters, corticoids, cancer, and previous antibiotic therapy were the main risk factors for these infections...
January 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Caroline Steward
As the number of patients requiring hemodialysis increases, so does the number of patients who require complex care and whose care requires a hospital hemodialysis unit setting rather than a freestanding unit. As a result, hospital units may have a higher ratio of complex patients, and some quality incentive program (QIP) measures may need modification to be meaningful in these settings.
January 2017: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
Wen-Yi Li, Yi-Cheng Wang, Shang-Jyh Hwang, Shih-Hua Lin, Kwan-Dun Wu, Yung-Ming Chen
BACKGROUND: The clinical consequences of starting chronic peritoneal dialysis (PD) after emergent dialysis via a temporary hemodialysis (HD) catheter has rarely been evaluated within a full spectrum of treated end-stage renal disease (ESRD). We investigated the longer-term outcomes of patients undergoing emergent-start PD in comparison with that of other practices of PD or HD in a prospective cohort of new-onset ESRD. METHODS: This was a 2-year prospective observational study...
December 11, 2017: BMC Nephrology
Stephanie Thompson, Natasha Wiebe, Scott Klarenbach, Rick Pelletier, Brenda R Hemmelgarn, John S Gill, Braden J Manns, Marcello Tonelli
BACKGROUND: For people requiring hemodialysis, infectious mortality is independently associated with geographic distance from a nephrologist. We aimed to determine if differential management of catheter-related blood stream infections (CRBSIs) could explain poorer outcomes. METHODS: We prospectively collected data from adults initiating hemodialysis with a central venous catheter between 2005 and 2015 in Alberta, Canada. We collected indicators of CRBSI management (timely catheter removal, relapsing bacteremia); frequency of CRBSIs; hospitalizations; predictors of CRBSIs, and bacteremia...
December 8, 2017: BMC Nephrology
Bruce E Reidenberg, Christoph Wanner, Bruce Polsky, Mariana Castanheira, Alla Shelip, Dirk Stalleicken, Antony E Pfaffle
Catheter-related bloodstream infections (CRBSI) are major complications for patients with life-threatening conditions requiring chronic vascular catheterization. The wide range of etiologic microbes and the ongoing development of resistance to antimicrobials with specific mechanisms of action make this an appropriate target for applying a nonspecific antimicrobial therapeutic. Taurolidine hydrolyzes into two antimicrobial moieties, formaldehyde and methylene glycol, which react with microbial surfaces. Neutrolin® (taurolidine, heparin, calcium citrate) was recently introduced in Germany as an antimicrobial catheter lock solution...
December 6, 2017: European Journal of Clinical Microbiology & Infectious Diseases
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