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dialysis catheter infection

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
Jonathan Owen, Vaughan Washco, Efrain Reisin
Sphingomonas paucimobilis is an uncommon source of peritonitis in patients undergoing peritoneal dialysis (PD). Although only a small number of cases have been reported, treatment failure rate is extremely high, with removal of the peritoneal dialysis catheter noted in ~ 50% of reported cases. The potential damage to the peritoneal membrane from peritonitis with this organism and the ability to return to PD after infection is unknown. We report a unique case in which a patient was able to successfully return to PD after relapsing Sphingomonas paucimobilis peritonitis, without apparent effects to dialysis clearance or ultrafiltration...
November 2016: Clinical Nephrology
Adam D Jakes, Poonam Jani, Victoria Allgar, Archie Lamplugh, Ahmed Zeidan, Sunil Bhandari
BACKGROUND: Dialysis in elderly patients (>80-years-old) carries a poor prognosis, but little is known about the most effective vascular access method in this age group. An arteriovenous fistula (AVF) is both time-consuming and initially expensive, requiring surgical insertion. A central venous catheter (CVC) is initially a cheaper alternative, but carries a higher risk of infection. We examined whether vascular access affected 1-year and 2-year mortality in elderly patients commencing haemodialysis...
2016: PloS One
Denise J Campbell, Jonathan C Craig, David W Mudge, Fiona G Brown, Germaine Wong, Allison Tong
♦ Background: Peritoneal dialysis (PD) is recommended for adults with residual kidney function and without significant comorbidities. However, peritonitis is a serious and common complication that is associated with hospitalization, pain, catheter loss, and death. This study aims to describe the beliefs, needs, and experiences of PD patients about peritonitis, to inform the training, support, and care of these patients. ♦ Methods: Qualitative semi-structured interviews were conducted with 29 patients from 3 renal units in Australia who had previous or current experience of PD...
September 28, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Philip H Li, Vincent C Cheng, Terence Yip, Desmond Y Yap, Sing-Leung Lui, Wai K Lo
♦ Background: Acinetobacter spp. is an important cause of peritoneal dialysis (PD)-related peritonitis, but studies on Acinetobacter peritonitis have been scarce. In view of the rising concern of carbapenem-resistant Acinetobacter (CRA) and multidrug-resistant Acinetobacter (MDRA) infections, we conducted this study on the incidence of Acinetobacter peritonitis and the impact of CRA and MDRA on its outcome. ♦ Methods: We retrospectively evaluated the clinical characteristics, prevalence, antibiotic sensitivity patterns, outcomes, and factors associated with treatment failure over the past 16 years in our patients with Acinetobacter PD-related peritonitis...
September 28, 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
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
Shefali Gupta, Shrikara P Mallya, Ashok Bhat, Shrikala Baliga
INTRODUCTION: Aerobic bacterial infections often complicate vascular access in patients receiving haemodialysis, leading to Catheter-Related Blood Stream Infections (CRBSI). Various studies report Gram - positive bacteria, Staphylococcus aureus (S. aureus) in particular, as the most common aetiologic agent. Studies on microbiological analysis in this subset of population from India are very few. AIM: To examine clinical and bacteriological profiles of haemodialysis patients developing CRBSI, the antibiotic susceptibility of the bacteria isolated from these patients and determine nasal carriage of S...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
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
Andrzej Ratajczak, Małgorzata Lange-Ratajczak, Adam Bobkiewicz, Adam Studniarek
This report reviews the most common surgical interventions and complications of chronic peritoneal dialysis (PD) patients. Based on the current knowledge as well as our experience we detail the role of these surgical procedures. We supplement the reported knowledge in the field with our own experience in this area. The areas discussed include early complications such as surgical wound hemorrhage, bleeding from the catheter, intestinal perforation and urinary bladder perforation, dialysate leakage through the wound, as well as late complications including catheter kinking or occlusion, retention of fluid in the peritoneal recess, hernias and hydrothorax, and encapsulating peritoneal sclerosis...
September 6, 2016: Seminars in Dialysis
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
Cibele Grothe, Mônica Taminato, Angélica Belasco, Ricardo Sesso, Dulce Barbosa
BACKGROUND: This study was performed to evaluate the clinical effectiveness of alternative strategies for the prevention and treatment of patients with chronic kidney disease undergoing peritoneal dialysis and colonized by Staphylococcus aureus. METHODS: A systematic review and meta-analysis were performed. The literature search involved the following databases: the Cochrane Controlled Trials Register, Embase, LILACS, CINAHL, SciELO, and PubMed/Medline. The descriptors were "Staphylococcus aureus," "MRSA," "MSSA," "treatment," "decolonization," "nasal carrier," "colonization," "chronic kidney disease," "dialysis," and "peritoneal dialysis...
2016: BMC Nephrology
Mauro Pittiruti, Sergio Bertoglio, Giancarlo Scoppettuolo, Roberto Biffi, Massimo Lamperti, Alberto Dal Molin, Nicola Panocchia, Nicola Petrosillo, Mario Venditti, Carla Rigo, Enrico DeLutio
BACKGROUND: The most appropriate lock solution for central venous access devices is still to be defined. GAVeCeLT - the Italian group for venous access devices - has developed a consensus on the evidence-based criteria for the choice and the clinical use of the most appropriate lock solution for central venous catheters (excluding dialysis catheters). METHOD: After the constitution of a panel of experts, a systematic collection and review of the literature has been performed, focusing on clinical studies dealing with lock solutions used for prevention of occlusion (heparin, citrate, urokinase, recombinant tissue plasminogen activator [r-TPA], normal saline) or for prevention of infection (citrate, ethanol, taurolidine, ethylene-diamine-tetra-acetic acid [EDTA], vancomycin, linezolid and other antibiotics), in both adults and in pediatric patients...
August 1, 2016: Journal of Vascular Access
Thawatchai Tullavardhana, Prinya Akranurakkul, Withoon Ungkitphaiboon, Dolrudee Songtish
BACKGROUND: Peritoneal dialysis (PD) is an effective method of renal replacement therapy for end-stage renal disease patients. The PD catheter could be inserted by surgical (open surgery/laparoscopic-assisted) or percutaneous techniques. However, the efficacy of the techniques, including catheter survival and catheter related complications, is still controversial. METHOD: The dataset was defined by searching PubMed, EMBASE, Google Scholar and the Cochrane database that had been published until July 2014...
September 2016: Annals of Medicine and Surgery
Elisabeth Coupez, Jean-François Timsit, Stéphane Ruckly, Carole Schwebel, Didier Gruson, Emmanuel Canet, Kada Klouche, Laurent Argaud, Julien Bohe, Maïté Garrouste-Orgeas, Christophe Mariat, François Vincent, Sophie Cayot, Olivier Cointault, Alain Lepape, Michael Darmon, Alexandre Boyer, Elie Azoulay, Lila Bouadma, Alexandre Lautrette, Bertrand Souweine
BACKGROUND: Intensive care unit (ICU) patients require dialysis catheters (DCs) for renal replacement therapy (RRT). They carry a high risk of developing end-stage renal disease, and therefore their vascular access must be preserved. Guidewire exchange (GWE) is often used to avoid venipuncture insertion (VPI) at a new site. However, the impact of GWE on infection and dysfunction of DCs in the ICU is unknown. Our aim was to compare the effect of GWE and VPI on DC colonization and dysfunction in ICU patients...
July 30, 2016: Critical Care: the Official Journal of the Critical Care Forum
Julio C U Coelho, Christiano M P Claus, Antonio C L Campos, Marco A R Costa, Caroline Blum
Umbilical hernia occurs in 20% of the patients with liver cirrhosis complicated with ascites. Due to the enormous intraabdominal pressure secondary to the ascites, umbilical hernia in these patients has a tendency to enlarge rapidly and to complicate. The treatment of umbilical hernia in these patients is a surgical challenge. Ascites control is the mainstay to reduce hernia recurrence and postoperative complications, such as wound infection, evisceration, ascites drainage, and peritonitis. Intermittent paracentesis, temporary peritoneal dialysis catheter or transjugular intrahepatic portosystemic shunt may be necessary to control ascites...
July 27, 2016: World Journal of Gastrointestinal Surgery
Damien Balestrino, Mercédès Quintana, Nicolas Charbonnel, Christiane Forestier, Claire Lartigue, Bertrand Souweine
BACKGROUND AND OBJECTIVES: Interdialytic lock solutions should maintain catheter patency and prevent catheter infections. We aimed to determine in which conditions injectable anticoagulant agents (IAAs) combined with ethanol are compatible and to assess the antibiofilm activity of the selected combination and its effects on dialysis catheters (DC). METHODS: The solubility and compatibility of unfractionated heparin (UFH), low molecular weight heparins (LMWHs), heparinoids and fondaparinux (50 to 2,500 U/mL) in 30 to 70% ethanol were determined by visual observation...
2016: PloS One
Jehad Almasri, Mouaz Alsawas, Maria Mainou, Reem A Mustafa, Zhen Wang, Karen Woo, David L Cull, M Hassan Murad
BACKGROUND: The decision about the type and location of a hemodialysis vascular access is challenging and can be affected by multiple factors. We explored the effect of several a priori chosen patient characteristics on access outcomes. METHODS: We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus through November 13, 2014. We included studies that evaluated patency, mortality, access infection, and maturation of vascular access in adults requiring long-term dialysis...
July 2016: Journal of Vascular Surgery
Christopher Sia, Scott Wilson, Michelle Ananda-Rajah, John Mills, Ar Kar Aung
We report the first case of Listeria monocytogenes peritoneal dialysis (PD) peritonitis in a human immunodeficiency virus-infected individual successfully treated with intraperitoneal ampicillin, without the need for catheter removal. Suspicion of listerial infection in at-risk individuals is critical as empiric antimicrobial treatment for PD-associated infections may be ineffective against this organism.
June 27, 2016: Clinical Nephrology
Christine B Sethna, Kristina Bryant, Raj Munshi, Bradley A Warady, Troy Richardson, John Lawlor, Jason G Newland, Alicia Neu
BACKGROUND AND OBJECTIVES: The Standardizing Care to Improve Outcomes in Pediatric ESRD Collaborative is a quality improvement initiative that aims to reduce peritoneal dialysis-associated infections in pediatric patients on chronic peritoneal dialysis. Our objectives were to determine whether provider compliance with peritoneal dialysis catheter care bundles was associated with lower risk for infection at the individual patient level and describe the epidemiology, risk factors, and outcomes for peritonitis in the Standardizing Care to Improve Outcomes in Pediatric ESRD Collaborative...
September 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
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