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https://www.readbyqxmd.com/read/28958447/an-outbreak-of-bloodstream-infection-due-to-extensively-resistant-acinetobacter-baumannii-among-neonates
#1
Aysegul Ulu-Kilic, Aycan Gundogdu, Fatma Cevahir, Huseyin Kilic, Tamer Gunes, Emine Alp
BACKGROUND: Extensively resistant Acinetobacter baumannii has emerged and spread worldwide as a significant cause of health care-associated infections and outbreaks. It also causes life-threatening infections among neonates, including bacteremia. The aim of this study was to investigate an outbreak of A baumannii bacteremia (ABB) among neonates. MATERIALS AND METHODS: A retrospective, case-control study was conducted from July 2014 to July 2015 in a neonatal intensive care unit (NICU)...
September 25, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28943826/the-use-of-daptomycin-to-treat-methicillin-resistant-staphylococcus-epidermidis-bacteremia-in-a-critically-ill-child-with-renal-failure
#2
Stephen Morris, Kate Gould, Lee P Ferguson
Daptomycin is excreted primarily unchanged by the kidney. Dosage regimens in children with renal failure remain to be determined. We report the case of an 8-year-old child with multiorgan failure undergoing continuous peritoneal dialysis, successfully treated with intravenous daptomycin for methicillin-resistant Staphylococcus epidermidis bacteremia. A dosage of 8 mg/kg every 48 hour was used. Plasma peak and trough concentrations of daptomycin were 68 mg/L and 14.6 mg/L, respectively, on day 6 of treatment...
July 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28818188/healthcare-outcomes-in-undocumented-immigrants-undergoing-two-emergency-dialysis-approaches%C3%A2
#3
S Jawad Sher, Waqas Aftab, Ranjani N Moorthi, Sharon M Moe, Christopher S Weaver, Frank C Messina, Nancy M Martinez-Hoover, Melissa D Anderson, Michael T Eadon
BACKGROUND: Current estimates suggest 6,500 undocumented end-stage renal disease (ESRD) patients in the United States are ineligible for scheduled hemodialysis and require emergent dialysis. In order to remain in compliance with Emergency Medicaid, an academic health center altered its emergency dialysis criteria from those emphasizing interdialytic interval to a set emphasizing numerical thresholds. We report the impact of this administrative change on the biochemical parameters, utilization, and adverse outcomes in an undocumented patient cohort...
August 17, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28814278/epidemiology-and-outcomes-of-endophthalmitis-in-chronic-dialysis-patients-a-13-year-experience-in-a-tertiary-referral-center-in-taiwan
#4
George Kuo, Yueh-An Lu, Wei-Chiao Sun, Chao-Yu Chen, Huang-Kai Kao, YuJr Lin, Chia-Hui Lee, Cheng-Chieh Hung, Ya-Chung Tian, Hsiang-Hao Hsu
BACKGROUND: Endophthalmitis is a severe eye infection leading to disabling outcome. Because there were only a few case report illustrating endophthalmitis in chronic dialysis patient, we would like to investigate the epidemiology and clinical features of endophthalmitis in chronic dialysis patient in a tertiary referral center. METHODS: We searched the health information system in the study hospital with ICD9 encoding endophthalmitis during Jan. 2002 to Dec. 2015...
August 16, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28623638/urokinase-containing-locking-solution-in-the-prevention-of-dialysis-catheter-dysfunction-a-double-blind-randomized-controlled-trial
#5
Florence Bonkain, Freya Van Hulle, Peter Janssens, Concetta Catalano, Mandelina Allamani, Jean-Claude Stolear, Dominique Vandervelde, Mark Libertalis, Serge Treille, Marie M Couttenye, Annemie Dhondt, Wim Van Biesen, Jean François Fils, Christian Tielemans, Karl M Wissing
INTRODUCTION: The prophylactic use of recombinant tissue plasminogen activator once weekly reduces the incidence rate of tunneled cuffed catheter (TCC) malfunction and bacteremia as compared to the exclusive use of heparin as locking solution. Restricting the use of prophylactic thrombolytic agents to patients with a history of thrombotic TCC malfunction could be more cost effective. We conduct a multicenter, double-blind, randomized controlled trial and test the hypothesis that weekly use of urokinase lock will reduce the incidence of thrombotic malfunction by 50% in prevalent hemodialysis patients with a history of thrombotic malfunction...
June 14, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28584849/carbapenem-resistant-enterobacteriaceae-infections-results-from-a-retrospective-series-and-implications-for-the-design-of-prospective-clinical-trials
#6
Elizabeth L Alexander, Jeffery Loutit, Mario Tumbarello, Richard Wunderink, Tim Felton, George Daikos, Karen Fusaro, Dan White, Shu Zhang, Michael N Dudley
BACKGROUND: The increasing incidence of multidrug-resistant Gram negatives, such as carbapenem-resistant Enterobacteriaceae (CRE), has resulted in a critical need for new antimicrobials. Most studies of new antimicrobials have been performed in patients with nondrug-resistant pathogens. We performed a retrospective analysis of patients with CRE infections to inform the design of phase 3 clinical trials. METHODS: This was a retrospective study at 22 centers in 4 countries...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28532398/clinical-outcomes-of-linezolid-and-vancomycin-in-patients-with-nosocomial-pneumonia-caused-by-methicillin-resistant-staphylococcus-aureus-stratified-by-baseline-renal-function-a-retrospective-cohort-analysis
#7
Ping Liu, Blair Capitano, Amy Stein, Ali A El-Solh
BACKGROUND: The primary objective of this study is to assess whether baseline renal function impacts treatment outcomes of linezolid and vancomycin (with a dose-optimized regimen) for methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. METHODS: We conducted a retrospective cohort analysis of data generated from a prospective, randomized, controlled clinical trial (NCT 00084266). The analysis included 405 patients with culture-proven MRSA pneumonia. Baseline renal function was stratified based on creatinine clearance...
May 22, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28485119/case-of-mycobacterium-mucogenicum-in-a-home-hemodialysis-patient
#8
Miten J Dhruve, Paul E Bunce, Celine D'Gama, Christopher T Chan
We present a case of a patient on home hemodialysis who developed Mycobacterium mucogenicum bacteremia. While infections with this particular organism are rare, disseminated infections have been reported and have been associated with significant morbidity and mortality. Diagnosis required appropriate cultures, understanding of natural habitat of organism and complete environmental analysis including blood, dialysis sample port, reverse osmosis and incoming water supply cultures. The patient was treated successfully with systemic antibiotics, removal of central venous catheter, patient education and complete exchange of the hemodialysis circuit...
October 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28429519/the-incidence-and-costs-of-bacteremia-due-to-lack-of-gentamicin-lock-solutions-for-dialysis-catheters
#9
Tze Liang Goh, Jason Wei, David Semple, John Collins
The use of antibiotic lock solutions as prophylaxis for catheter-associated blood stream infection (CRBSI) has been shown to be effective in previous randomized controlled trials. However, the cost-effectiveness of this approach had not been studied. In 2012, the routine gentamicin-heparin lock solution used in Auckland City Hospital was withdrawn from the market, leading to a change to heparin-only lock. This was then replaced with gentamicin-citrate lock in 2014. This situation allowed review of the CRBSI rate and financial impact of different catheter lock solutions...
June 2017: Nephrology
https://www.readbyqxmd.com/read/28416553/pharmacokinetics-and-dialytic-clearance-of-ceftazidime-avibactam-in-a-critically-ill-patient-on-continuous-venovenous-hemofiltration
#10
Eric Wenzler, Kristen L Bunnell, Susan C Bleasdale, Scott Benken, Larry H Danziger, Keith A Rodvold
Ceftazidime-avibactam administered at 1.25 g every 8 h was used to treat multidrug-resistant Pseudomonas aeruginosa bacteremia in a critically ill patient on continuous venovenous hemofiltration (CVVH). Prefiltration plasma drug concentrations of ceftazidime and avibactam were measured at 0, 1, 2, 4, 6, and 8 h along with postfiltration and ultrafiltrate concentrations at h 2 and h 6. Plasma pharmacokinetic parameters of ceftazidime and avibactam, respectively, were as follows: maximum plasma concentration (Cmax), 61...
July 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27993572/chills-during-hemodialysis-prediction-and-prevalence-of-bacterial-infections-a-retrospective-cohort-study
#11
Daniel Shepshelovich, Dana Yelin, Lior Or Bach, Noy Halevy, Yonatan Ziv, Hefziba Green, Benaya Rozen-Zvi, Haim Ben-Zvi, Jihad Bishara, Anat Gafter-Gvili, Dafna Yahav
INTRODUCTION: Chills are a complication of patients undergoing hemodialysis. The rate of infection among hemodialysis patients presenting with chills is not well established, and empirical broad-spectrum antibiotics are usually the rule. METHODS: We performed a retrospective study aiming to assess the rates of infection and bacteremia in hemodialysis patients presenting with chills. We evaluated risk factors for infection and bacteremia and tested a prediction model for infection...
April 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/27988089/predictors-of-mortality-among-u-s-veterans-with-streptococcus-pneumoniae-infections
#12
Jacob B Morton, Haley J Morrill, Kerry L LaPlante, Aisling R Caffrey
INTRODUCTION: Serious Streptococcus pneumoniae infections, encompassing pneumonia, bacteremia, and meningitis, are a major cause of mortality. However, literature regarding mortality is often limited to invasive pneumococcal disease, excluding pneumonia. This study sought to identify predictors of mortality among adults with serious pneumococcal disease, including pneumonia and invasive pneumococcal disease. METHODS: This was a nested case-control study of unvaccinated older Veterans with positive S...
December 14, 2016: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/27942955/management-dilemmas-in-pediatric-nephrology-time-limited-trials-of-dialysis-therapy
#13
Aaron Wightman
BACKGROUND: Time-limited trials of dialysis have been proposed as a third option in addition to initiation of treatment and comfort-care only in the setting of high uncertainty or discordance between the treating team and child/family or among the treating team. CASE-DIAGNOSIS/TREATMENT: The index case was noted antenatally to have severe kidney disease and pulmonary hypoplasia. In light of the guarded, but uncertain prognosis and a lack of consensus among the treating team, as well as between the treating team and the family, a time-limited trial of dialysis was initiated...
April 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27939820/colistin-resistant-enterobacteriaceae-infections-clinical-and-molecular-characterization-and-analysis-of-in-vitro-synergy
#14
Claudia M D de Maio Carrillho, Juliana J Gaudereto, Roberta Cristina Ruedas Martins, Victor Augusto Camarinha de Castro Lima, Larissa M de Oliveira, Mariana R Urbano, Jamile S Perozin, Anna Sara Levin, Silvia F Costa
We described 27 polyclonal colistin-resistant Enterobacteriaceae (MIC 4-16 μg/mL) infections (12 pneumonia, 12 urinary tract infection (UTI), two Bacteremia, and one skin/soft tissue infection) in which 74% harbored KPC. The isolates were polyclonal, 6 STs were identified and the colistin resistance was due to chromosome mutations. Eight patients with UTI received monotherapy, and combination therapy was given to 19 patients. Overall mortality was 37%. In vitro synergy using time-kill assay was observed in 14 of 19 (74%) isolates tested; the synergistic effect was observed for almost all isolates for the combination of three drugs: colistin, amikacin, and tigecycline...
March 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/27910867/effects-of-annual-influenza-vaccination-on-morbidity-and-mortality-in-patients-with-systemic-lupus-erythematosus-a-nationwide-cohort-study
#15
Chi-Ching Chang, Yu-Sheng Chang, Wei-Sheng Chen, Yi-Hsuan Chen, Jin-Hua Chen
Studies on the clinical efficacy of influenza vaccination on patients with systemic lupus erythematosus (SLE) are scant. The present study compared the incidence of hospitalization, morbidity, and mortality in patients with SLE between cohorts with and without influenza vaccination. We used the Taiwan's insurance claims data between 2001 and 2012 for identifying annual adult patients with SLE with (N = 1765) and without (N = 8360) influenza vaccination. The incidence rate ratio and hazard ratio (HR) for morbidities and mortality were measured for the vaccine and nonvaccine cohorts...
December 2, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27824950/urgent-start-peritoneal-dialysis-and-hemodialysis-in-esrd-patients-complications-and-outcomes
#16
Haijiao Jin, Wei Fang, Mingli Zhu, Zanzhe Yu, Yan Fang, Hao Yan, Minfang Zhang, Qin Wang, Xiajing Che, Yuanyuan Xie, Jiaying Huang, Chunhua Hu, Haifen Zhang, Shan Mou, Zhaohui Ni
BACKGROUND: Several studies have suggested that urgent-start peritoneal dialysis (PD) is a feasible alternative to hemodialysis (HD) in patients with end-stage renal disease (ESRD), but the impact of the dialysis modality on outcome, especially on short-term complications, in urgent-start dialysis has not been directly evaluated. The aim of the current study was to compare the complications and outcomes of PD and HD in urgent-start dialysis ESRD patients. METHODS: In this retrospective study, ESRD patients who initiated dialysis urgently without a pre-established functional vascular access or PD catheter at a single center from January 2013 to December 2014 were included...
2016: PloS One
https://www.readbyqxmd.com/read/27737913/clostridium-difficile-infection-in-dialysis-patients
#17
Ankita Tirath, Sandra Tadros, Samuel L Coffin, Kristina W Kintziger, Jennifer L Waller, Stephanie L Baer, Rhonda E Colombo, Lu Y Huber, Mufaddal F Kheda, N Stanley Nahman
Clostridium difficile infection (CDI) is the most common cause of nosocomial diarrhea. Patients with end-stage renal disease (ESRD) may be at increased risk for CDI. Patients with ESRD with CDI have increased mortality, longer length of stay, and higher costs. The present studies extend these observations and address associated comorbidities, incidence of recurrence, and risk factors for mortality. We queried the United States Renal Data System (USRDS) for patients with ESRD diagnosed with CDI, and assessed for the incidence of infection, comorbidities, and mortality...
February 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/27451865/outcome-assessment-of-renal-replacement-therapy-in-neonates
#18
Ilan I Maizlin, Michelle C Shroyer, Lena Perger, Mike K Chen, Elizabeth A Beierle, Colin A Martin, Scott A Anderson, Vincent E Mortellaro, David A Rogers, Robert T Russell
BACKGROUND: Recent advances in renal replacement therapy (RRT) have brought about a proliferation of dialysis in neonates (<30 d). This study aimed to assess morbidity and mortality after RRT initiation in this population. METHODS: Retrospective chart review of all patients between 2006 and 2014 requiring RRT initiated in the first 30 d of life was performed. RESULTS: A total of 49 patients were identified, of which 39 were boys and 10 were girls...
July 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27410414/ralstonia-pickettii-bacteremia-in-hemodialysis-patients-a-report-of-two-cases
#19
Darwin Tejera, Gino Limongi, Mauricio Bertullo, Mario Cancela
Ralstonia pickettii is a low-virulence gram-negative bacillus that may be associated with infections related to health care and may cause bacteremia. Ralstonia pickettii bacteremia is uncommon but is related to the contamination of medical products, mainly in immunodepressed patients. We present two cases of patients on chronic hemodialysis with Ralstonia pickettii bacteremia linked to contamination of the dialysis water. Similar cases have been published with links to intravenous fluid administration, medication ampules, and the use of extracorporeal oxygenation membranes, among other factors...
June 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/27339573/bacteremia-prevalence-and-antimicrobial-resistance-profiling-in-chronic-kidney-diseases-and-renal-transplant-patients
#20
Bushra Jamil, Mohammad Tauseef Mukhtar Bokhari, Azhar Saeed, Mohammad Zahid Mukhtar Bokhari, Zakir Hussain, Tayabba Khalid, Habib Bukhari, Muhammad Imran, Shahid Ahmad Abbasi
OBJECTIVE: To determine the prevalence of bacteraemia in patients with chronic kidney disease, particularly those on dialysis and those who had had renal transplant, and to evaluate resistance among the isolated strains. METHODS: The cross-sectional study was conducted at Kidney Centre, Al-Sayyed Hospital, Rawalpindi, Pakistan, from June to December 2014. Samples that displayed positive growth were separated from the rest. The isolates were then identified and screened for extended spectrum beta lactamases and metallo beta lactamases production and other resistance mechanisms by phenotypic method...
June 2016: JPMA. the Journal of the Pakistan Medical Association
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