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Bacteremia dialysis

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https://www.readbyqxmd.com/read/29605379/bacteriology-of-the-buttonhole-cannulation-tract-in-hemodialysis-patients-a-prospective-cohort-study
#1
Line Dahlstrøm Christensen, Mai-Britt Skadborg, Agnete H Mortensen, Carsten Mortensen, Jens K Møller, Lars Lemming, Irene Høgsberg, Steffen E Petersen, Niels H Buus
BACKGROUND: The buttonhole cannulation technique for arteriovenous fistulas is widely used, but has been associated with an increased rate of vascular access-related infections. We describe the frequency and type of bacterial colonization of the buttonhole tract over time and associated clinical infections. STUDY DESIGN: A prospective observational cohort study with 9 months of follow-up. SETTING & PARTICIPANTS: 84 in-center hemodialysis patients using the buttonhole cannulation technique at 2 Danish dialysis centers...
March 29, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29575970/medical-management-of-endocarditis-caused-by-stenotrophomonas-maltophilia-a-case-report
#2
Sunish Shah, Madeline King, Lucia Rose
A 44-year-old female was found to be systemically ill at dialysis and admitted to the hospital. Days into the hospitalization, her blood cultures from dialysis were positive with Stenotrophomonas maltophilia bacteremia with a levofloxacin minimum inhibitory concentration (MIC) of 1. She was discharged on ciprofloxacin 500 mg orally (PO) daily on hospital day 2 to complete a 14-day course. Weeks later, she was again found to be bacteremic at dialysis and sent back to the hospital. She was started on empiric antibiotics upon admission until further identification...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29506430/pregnancy-and-hemodialysis-access-a-case-for-patient-satisfaction-in-favor-of-a-tunneled-dialysis-catheter
#3
Sushil Mehandru, Attiya Haroon, Avais Masud, Mayurkumar Patel, Elmer Sadiang-Abay, Eric J Costanzo, Tushar J Vachharajani
While an arteriovenous fistula is the best available access, many patients continue to rely on a tunneled hemodialysis catheter for dialysis therapy. Despite the highest risk of catheter-related bacteremia and associated morbidity and mortality, patients often prefer tunneled hemodialysis catheter to avoid pain associated with cannulation of an arteriovenous access. We report three tunneled hemodialysis catheter-dependent end-stage renal disease patients (age: 38, 35, 33 years), who became pregnant. Pregnancy was discovered at 10, 12 and 10 weeks of gestation...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29505620/the-ratio-of-pre-dialysis-vancomycin-trough-serum-concentration-to-minimum-inhibitory-concentration-is-associated-with-treatment-outcomes-in-methicillin-resistant-staphylococcus-aureus-bacteremia
#4
Chien-Fang Fu, Jiun-Da Huang, Jann-Tay Wang, Shu-Wen Lin, Chien-Chih Wu
BACKGROUND: Vancomycin is a standard treatment for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia, and its efficacy is closely linked to the recommended serum trough concentration of 15-20 mg/L. However, it is unknown how the pre-dialysis trough serum concentration (Cpre-HD) correlates with MRSA eradication in renal failure patients undergoing intermittent hemodialysis (HD). OBJECTIVE: To evaluate the relationship between Cpre-HD and the treatment outcomes in this population...
2018: PloS One
https://www.readbyqxmd.com/read/29305961/no-effect-of-vancomycin-mic-%C3%A2-1-5-mg-l-on-treatment-outcome-in-methicillin-susceptible-staphylococcus-aureus-bacteraemia
#5
Kevin Bouiller, Caroline Laborde, Serge Ludwig Aho, Didier Hocquet, André Pechinot, Vincent Le Moing, Xavier Bertrand, Lionel Piroth, Catherine Chirouze
The vancomycin minimum inhibitory concentration (MIC) has been shown to affect the outcome of methicillin-susceptible Staphylococcus aureus (MSSA) bacteraemia. In this study, the outcomes of patients with MSSA bacteraemia with a vancomycin MIC ≥ 1.5 mg/L were assessed. A prospective cohort of patients with MSSA bacteraemia in two tertiary-care hospitals was collected. The vancomycin MIC was determined by Etest. Staphylococcus aureus strains were categorised as low (<1.5 mg/L) or high (≥1.5 mg/L) vancomycin MIC...
January 3, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29221439/catheter-related-blood-stream-infections-in-hemodialysis-patients-a-prospective-cohort-study
#6
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
https://www.readbyqxmd.com/read/29162336/insights-from-the-2016-peer-kidney-care-initiative-report-still-a-ways-to-go-to-improve-care-for-dialysis-patients
#7
James B Wetmore, Suying Li, Julia T Molony, Haifeng Guo, Charles A Herzog, David T Gilbertson, Yi Peng, Allan J Collins
Although outcomes improved during the past decade for patients receiving maintenance dialysis, gains were few in certain key areas, as highlighted in the 2016 Peer Kidney Care Initiative Report. Overall incidence rates of dialysis therapy initiation in adults remained relatively stable (∼42 per 100,000 US population, 2009-2013), but rates varied more than 2-fold, from 26 to 54, across US geographic regions. Hospitalization rates in incident patients decreased from 261 hospitalizations per 100 patient-years in 2003 to 207 in 2012, but observation stay rates increased from 40 to 67, attenuating the decline in hospitalizations by half...
January 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28958447/an-outbreak-of-bloodstream-infection-due-to-extensively-resistant-acinetobacter-baumannii-among-neonates
#8
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
#9
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
#10
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...
October 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
#11
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
#12
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...
September 11, 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
#13
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
#14
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
#15
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
#16
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
#17
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 ( C max ), 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
#18
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
#19
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
#20
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
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