Amikacin hemodialysis

Rhizobium radiobacter is a Gram-negative, nitrogen-fixing bacterium, which is found mainly on the ground. It rarely causes infections in humans. It has been associated with bacteremia, secondary to colonization of intravascular catheters, in immunocompromised patients. The aim of this paper was to report the case of an infective endocarditis caused by R. radiobacter, in a 47-year-old male, diagnosed with chronic kidney disease stage 5, on replacement therapy with hemodialysis and who attended the medical center with fever of two weeks duration...

INTRODUCTION: Hemodialysis (HD) patients are predisposed to infective endocarditis (IE) mainly due to repeated manipulation of the vascular access. However, catheter seeding and IE may also result from a distant infection site. CASE SERIES: A diabetic patient who was maintained on regular HD through a permanent catheter in the right internal jugular vein presented with septicemia of urinary origin due to Pseudomonas aeruginosa. He was treated with injectable antibiotics for 15 days...

OBJECTIVE: To investigate the pathogens and their resistance in continuous ambulatory peritoneal dialysis (CAPD) related peritonitis. METHODS: A total of 78 cases with CAPD related peritonitis from Xiangya Hospital between January 2007 and January 2011 were reviewed. Pathogens, resistance and outcomes of the 78 cases CAPD related peritonitis were analyzed retrospectively. RESULTS: Among them, 53 cases cultured positive (66.67%), 3 of which were combined infection and 2 strains were cultured...

UNLABELLED: Abstract Background: BAY41-6551, a drug-device combination in development for adjunctive treatment of Gram-negative pneumonia in mechanically ventilated patients, consists of amikacin formulated for inhalation coupled with the Pulmonary Drug Delivery System (PDDS) Clinical aerosol delivery platform. This study evaluated safety, tolerability, and pharmacokinetics (PK) of BAY41-6551 in subjects with chronic kidney disease (CKD). METHODS: Single doses of BAY41-6551 (400 mg amikacin) were administered using the PDDS Clinical handheld device to six subjects with mild-to-moderate (Group 1) and six subjects with severe renal impairment (Group 2)...

Infection of permanent catheters (Permcath) in hemodialysis (HD) patients can lead to catheter removal. The successful use of an antibiotic-lock to treat infection has reported good results in the treatment of catheters' infections. This study was designed to evaluate the impact of the intraluminal vancomycin in comparison with intravenous antibiotic administration. We included 67 (37 males and 30 females) chronic HD patients requiring Permcath insertion at our tertiary care hospital from July 2004 to June 2007...

Gram-negative pathogen-induced continuous ambulatory peritoneal dialysis- (CAPD) related peritonitis is increasing, especially that caused by enteric pathogens. We describe a 54-year-old Taiwanese man with a case of Campylobacter jejuni-mediated CAPD-related peritonitis and bacteremia. Positive Campylobacter jejuni dialysate and blood cultures confirmed the diagnosis of CAPD-mediated systemic infection. We initially administered intraperitoneal ceftazidime, amikacin and oral azithromycin, but the patient did not recover...

Mycobacterium neoaurum, a member of the Mycobacterium parafortuitum complex, has only rarely been reported as a pathogen of human infections. We report a case of catheter-related bloodstream infection (CRBSI) due to M. neoaurum in a patient on hemodialysis. The isolate was identified by conventional methods as well as by 16S rRNA gene analysis. The patient was successfully treated with intravenous antibiotics (meropenem and amikacin) for three weeks and the catheter was removed. M. neoaurum should be considered as a possible cause of CRBSI in patients with renal failure...

One of the leading problems encountered in patients undergoing peritoneal dialysis is infectious complications including peritonitis. We aimed to investigate the etiology, clinical presentation and therapy of peritonitis attacks in patients undergoing peritoneal dialysis (PD) in two ultimate hospitals in Eskisehir (located at middle Anatolia region of Turkey) over seven years. We determined 179 peritonitis attacks in 74 (62.2%) of 119 patients undergoing PD. The average annual peritonitis incidence in PD patients was found as 0...

A good vascular access is the lifeline of patients on long-term hemodialysis (HD) and anteriovenous fistula is considered the ideal access. Vascular access related septicemia (VARS) is the second most common cause of mortality among HD patients. Such infections could also lead to loss of vascular access unless specific measures are taken to preserve the accesses. The present study was designed to determine the incidence of septicemia, common bacterial flora involved, and impact of early, empirical antibiotic therapy on vascular access salvage among HD patients...

BACKGROUND: Mutiresistant bacterial infections are an emerging problem in the nosocomial setting. Our objectives were to describe the incidence, outcome, and risk factors for acquisition of multiresistant bacteria among renal transplant recipients. METHODS: We prospectively followed patients undergoing kidney transplantation over a 3-year period. We collected demographic features, underlying chronic diseases, and main transplant characteristics and complications...

Hemodialysis catheter related infections (HCRI) are one of the major causes of increasing mortality, morbidity and cost of therapy in hemodialysis patients. Prevention of HCRI requires the identification of predisposing risk factors. To determine the frequency of HCRI risk factors, we studied 116 patients (54% male, mean age of 49.5+/-16 years) patients with HCRI between 2003-2004. Forty one percent of the patients were diabetic. There was a history of previous catheter placement and infection in 41% and 32% of patients, respectively...

Bacteremias in inpatient chronic HD units have been described, but there is little information on bacteremias in ambulatory HD units. To determine the frequency of bacteremia and pathogen distribution in ambulatory chronic HD units, we retrospectively reviewed our experience with 107 bacteremias in 5 chronic ambulatory HD units over a 3 year period. The object of the study was twofold. The first objective was to determine if bacteremias in ambulatory HD setting were substantially different in frequency or type than in the inpatient HD setting...

BACKGROUND: The prevalence of resistance to imipenem and ceftazidime among Pseudomonas aeruginosa isolates is increasing worldwide. OBJECTIVE: Risk factors for nosocomial recovery (defined as the finding of culture-positive isolates after hospital admission) of imipenem-resistant P. aeruginosa (IRPA) and ceftazidime-resistant P. aeruginosa (CRPA) were determined. DESIGN: Two separate case-control studies were conducted. Control subjects were matched to case patients (ratio, 2:1) on the basis of admission to the same ward at the same time as the case patient...

Continuous renal replacement therapy (CRRT) is now commonly used as a means of support for critically ill patients with renal failure. No recent comprehensive guidelines exist that provide antibiotic dosing recommendations for adult patients receiving CRRT. Doses used in intermittent hemodialysis cannot be directly applied to these patients, and antibiotic pharmacokinetics are different than those in patients with normal renal function. We reviewed the literature for studies involving the following antibiotics frequently used to treat critically ill adult patients receiving CRRT: vancomycin, linezolid, daptomycin, meropenem, imipenem-cilastatin, nafcillin, ampicillin-sulbactam, piperacillin-tazobactam, ticarcillin-clavulanic acid, cefazolin, cefotaxime, ceftriaxone, ceftazidime, cefepime, aztreonam, ciprofloxacin, levofloxacin, moxifloxacin, clindamycin, colistin, amikacin, gentamicin, tobramycin, fluconazole, itraconazole, voriconazole, amphotericin B (deoxycholate and lipid formulations), and acyclovir...

We report an unusual case of Acinetobacter baumannii (A. baumannii) bacteremia in a man without significant comorbidities. A 50-year-old man who noticed a sudden onset of high fever was admitted to Kobe Nishi City Hospital. After the admission, his condition deteriorated rapidly with development of shock, anuria and agitation. Antibiotic therapy with meropenem and amikacin was begun for suspected septic shock along with the mechanical ventilation and continuous hemodialysis. Venous blood cultures yielded A...

BACKGROUND: Dialyzers reprocessed with chlorine-based solutions have been associated with increases in ultrafiltration coefficient and middle-molecule removal. Increased pore size has been hypothesized as the mechanism for the latter phenomenon. Dialyzers exposed to Amukin-D (Amuchina Int Inc, Gaithersburg, MD), a chlorine-based reprocessing agent, were evaluated for changes in molecular weight (MW) cutoff and ultrafiltration properties. METHODS: In vitro MW cutoff studies were performed on Fresenius F-80A (Fresenius, Lexington, MA) and Gambro Polyflux 17 (Gambro, Lakewood, CO) hemodialyzers that were reprocessed 20 times using Amukin-D...

Atrial septal aneurysm (ASA) is a well known morphologic abnormality and has been largely investigated with both transthoracic (TTE) and/or transesophageal echocardiography (TEE). Its association with other congenital and acquired heart diseases and midsystolic clicks has been reported. ASA also may be associated with an increased risk of embolic events. In many cases, it is an incidental finding. We describe a patient with acute renal failure associated with nephrotoxic drugs and ASA suggesting endocarditis...

Gram-negative septicemia due to central venous catheter-related infection is a leading cause of mortality and morbidity among patients who undergo hemodialysis. Antibiotic-heparin locks are valuable for preserving access sites and lowering the cost and inconvenience associated with central venous catheter replacement and surgical interventions. The optimal duration of use of an antibiotic-heparin lock is unknown. Prolonged use of an amikacin-heparin lock may lead to severe irreversible sensory-neural hearing loss...

PURPOSE: We sought to quantify the incidence of, define risk factors for, and examine the relation between renal functional impairment and treatment with conventional amphotericin B. SUBJECTS AND METHODS: We performed a 9-year retrospective analysis of amphotericin B-associated nephrotoxicity in 494 adult inpatients who received > or = 2 doses of amphotericin B. Nephrotoxicity was classified according to two nonmutually exclusive severity categories (50% increase or doubling in the baseline creatinine level)...

We report the first case of chronic ambulatory peritoneal dialysis-associated peritonitis caused by Mycobacterium phlei. This organism was isolated from the peritoneal fluid of a patient who presented with recurrent episodes of "culture-negative" peritonitis. The therapeutic regimen was based on previous experience with other rapidly growing atypical mycobacteria, and included removal of the Tenckhoff catheter, institution of hemodialysis, and anti-mycobacterial therapy with amikacin, cefoxitin, and doxycycline...