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https://www.readbyqxmd.com/read/27037271/evaluating-approaches-for-the-diagnosis-of-hemodialysis-catheter-related-bloodstream-infections
#1
Friederike Quittnat Pelletier, Mohammad Joarder, Susan M Poutanen, Charmaine E Lok
BACKGROUND AND OBJECTIVES: Guideline-recommended diagnostic criteria for hemodialysis (HD) catheter-related bloodstream infections (CRBSIs) are based on data from indwelling central catheters in patients not on HD and non-HD situations, and upon which peripheral vein cultures are the gold standard. We aimed to examine the validity of these criteria in patients on HD. DESIGN, SETTINGS, PARTICIPANTS, & MEASUREMENTS: Adult patients on in-center HD using catheters were prospectively followed from 2011 to 2014 at a large academic-based HD facility (Toronto, Canada)...
May 6, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/26733573/antimicrobial-lock-solutions-for-the-prevention-of-catheter-related-infection-in-patients-undergoing-haemodialysis-study-protocol-for-network-meta-analysis-of-randomised-controlled-trials
#2
Jun Zhang, Rong-Ke Li, Kee-Hsin Chen, Long Ge, Jin-Hui Tian
INTRODUCTION: Catheter-related infection (CRI) is a difficult clinical problem in renal medicine, with blood stream infections occurring in up to 40% of patients with haemodialysis (HD) catheters, conferring significant rates of morbidity and mortality. Several approaches have been assessed as a means to prevent CRI. Currently, an intervention that is the source of much discussion is the use of antimicrobial lock solutions (ALS). A number of past conventional meta-analyses have compared different ALS with heparin...
2016: BMJ Open
https://www.readbyqxmd.com/read/26141306/cathasept-line-lock-and-microbial-colonization-of-tunneled-hemodialysis-catheters-a-multicenter-randomized-controlled-trial
#3
RANDOMIZED CONTROLLED TRIAL
Muhammad Kanaa, Mark J Wright, Habib Akbani, Paul Laboi, Sunil Bhandari, Jonathan A T Sandoe
BACKGROUND: Catheter-related bloodstream infections (CRBSIs) cause morbidity and mortality in hemodialysis (HD) patients. Cathasept (tetra-sodium EDTA) solution has antimicrobial and anticoagulant activities. STUDY DESIGN: Multicenter prospective randomized controlled study. SETTING & PARTICIPANTS: 117 maintenance HD patients with confirmed uncolonized tunneled HD catheters from 4 HD centers. INTERVENTION: Patients were randomly assigned to receive Cathasept 4% locks (Cathasept group) or stayed with heparin 5,000 U/mL locks (heparin group), filled thrice weekly according to catheter lumen volume until the catheter was removed or for a maximum of 8 months...
December 2015: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/25248485/usefulness-of-endoluminal-catheter-colonization-surveillance-cultures-to-reduce-catheter-related-bloodstream-infections-in-hemodialysis
#4
Patricia Brañas, Enrique Morales, Francisco Ríos, Francisca Sanz, Eduardo Gutiérrez, Nuria Quintanilla, M Angeles Orellana, Mercedes Sánchez, Almudena Rodríguez-Aranda, Fernando Chaves
BACKGROUND: To evaluate the use of surveillance cultures (SCs) to prevent catheter-related bloodstream infections (CRBSIs) in asymptomatic hemodialysis (HD) patients. METHODS: In 2011-2012, we conducted a prospective study of HD patients with tunneled cuffed central venous catheters (TCCs). Colonization of the catheter lumen was assessed every 15 days by inoculating ~5 mL endoluminal blood into aerobic culture bottles. Individual patients were triaged based on SC results: group 1 (negative); group 2 (coagulase-negative Staphylococcus [CoNS] with time-to-positivity (TTP) >14 hours); group 3 (CoNS with TTP ≤14 hours); and group 4 (any microorganism other than CoNS and any TTP)...
November 2014: American Journal of Infection Control
https://www.readbyqxmd.com/read/24001331/infection-and-hemodialysis-access-an-updated-review
#5
REVIEW
Vineet Gupta, Mohamed H Yassin
The incidence of end-stage renal disease (ESRD) has almost doubled over past 2 decades. Despite decreasing overall hospital admission rates for ESRD population, the rate of infection-related hospitalizations has steadily increased. Infection remains the second most common cause of mortality in this patient population. Specifically, in the hemodialysis (HD) patients, the vascular access related infections are the most common identifiable source of infection. This concise review provides an update on the bacteremia related to vascular access primarily the catheters (Catheter Related Blood Stream Infection- CRBSI) in HD patients emphasizing on the determinants ranging from the epidemiology to pathogenesis, risk factors, cost implications and prevention...
June 2013: Infectious Disorders Drug Targets
https://www.readbyqxmd.com/read/23121768/a-randomised-controlled-trial-of-heparin-versus-ethanol-lock-therapy-for-the-prevention-of-catheter-associated-infection-in-haemodialysis-patients-the-healthy-cath-trial
#6
RANDOMIZED CONTROLLED TRIAL
Jennifer K Broom, Rathika Krishnasamy, Carmel M Hawley, E Geoffrey Playford, David W Johnson
BACKGROUND: Tunnelled central venous dialysis catheter use is significantly limited by the occurrence of catheter-related infections. This randomised controlled trial assessed the efficacy of a 48 hour 70% ethanol lock vs heparin locks in prolonging the time to the first episode of catheter related blood stream infection (CRBSI). METHODS: Patients undergoing haemodialysis (HD) via a tunnelled catheter were randomised 1:1 to once per week ethanol locks (with two heparin locks between other dialysis sessions) vs thrice per week heparin locks...
2012: BMC Nephrology
https://www.readbyqxmd.com/read/22805387/cefotaxime-heparin-lock-prophylaxis-against-hemodialysis-catheter-related-sepsis-among-staphylococcus-aureus-nasal-carriers
#7
RANDOMIZED CONTROLLED TRIAL
Anil K Saxena, Bodh R Panhotra, Abdul Aziz Al-hafiz, Dasappan S Sundaram, Bassam Abu-Oyun, Khalifa Al Mulhim
Staphylococcus aureus nasal carriers undergoing hemodialysis (HD) through tunneled cuffed catheters (TCCs) form a high-risk group for the development of catheter-related bloodstream infections (CRBSI) and ensuing morbidity. The efficacy of antibiotic-locks on the outcomes of TCCs among S. aureus nasal carriers has not been studied earlier. Persistent nasal carriage was defined by two or more positive cultures for methicillin-susceptible (MSSA) or methicillin-resistant (MRSA) S. aureus of five standardized nasal swabs taken from all the participants dialyzed at a large out-patient HD center affiliated to a tertiary care hospital...
July 2012: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/22266591/tunneled-hemodialysis-catheter-related-bloodstream-infections-a-prospective-multicenter-cohort-study-from-spain
#8
MULTICENTER STUDY
Almudena Martín-Peña, Rafael Luque Márquez, M José Marco Guerrero, Nuria Espinosa, Yolanda Blanco, José Ibeas, Ma José Ríos-Villegas, José Miguel Cisneros
PURPOSE: Catheter-related bloodstream infections (CRBSI) are common among patients undergoing long-term hemodialysis (HD) worldwide. The aim of this study was look into the incidence, epidemiology, and risk factors for CRBSI in four medical centers and Spanish dialysis facilities following a common protocol for insertion and management of tunneled hemodialysis catheters (THCs). METHODS: Prospective study including all THCs inserted from September-04 to October-05...
April 2012: Journal of Vascular Access
https://www.readbyqxmd.com/read/22260745/locking-tunneled-hemodialysis-catheters-with-hypertonic-saline-26-nacl-and-heparin-to-prevent-catheter-related-bloodstream-infections-and-thrombosis-a-randomized-prospective-trial
#9
RANDOMIZED CONTROLLED TRIAL
Nilufer Oguzhan, Cigdem Pala, Murat Hayri Sipahioglu, Havva Cilan, Suleyman Durmaz, Duygu Percin, Aydin Unal, Bulent Tokgoz, Cengiz Utas, Oktay Oymak
OBJECTIVE: Tunneled cuffed dual-lumen catheters (TCCs) are commonly used for vascular access in hemodialysis (HD) patients. Catheter-related bloodstream infection (CRBSI) is the major problem leading to morbidity and mortality. We investigated whether 26% NaCl solution has any favorable effect on the infections and thrombosis caused by HD catheters. METHODS: TCCs were locked with either 26% NaCl and heparin or standard heparin. The primer end point of the study was the CRBSI or thrombosis of the TCC...
2012: Renal Failure
https://www.readbyqxmd.com/read/22074188/linezolid-versus-vancomycin-antibiotic-lock-solution-for-the-prevention-of-nontunneled-catheter-related-blood-stream-infections-in-hemodialysis-patients-a-prospective-randomized-study
#10
RANDOMIZED CONTROLLED TRIAL
Sofia Sofroniadou, Ioanna Revela, Despina Smirloglou, Ioanna Makriniotou, Sinodi Zerbala, Alexandros Kouloubinis, George Samonis, Christos Iatrou
The use of antibiotic lock solutions (ALSs) for the prevention of catheter-related blood stream infections (CRBSIs) is a promising option. The efficacy and safety of linezolid as ALS were evaluated in a randomized double-blind prospective study where 131 patients who required nontunneled catheter (NTC) for hemodialysis (HD) were randomized to receive an ALS with either (A) unfractionated heparin (2000 U/ml) alone as a catheter lock control, (B) vancomycin (5 mg/ml) + heparin (2000 U/ml), or (C) linezolid (2 mg/ml) + heparin (2000 U/ml)...
May 2012: Seminars in Dialysis
https://www.readbyqxmd.com/read/20702529/endoluminal-colonization-as-a-risk-factor-for-coagulase-negative-staphylococcal-catheter-related-bloodstream-infections-in-haemodialysis-patients
#11
Almudena Rodríguez-Aranda, Jose María Alcazar, Francisca Sanz, Florencio García-Martín, Joaquín R Otero, Jose Maria Aguado, Fernando Chaves
BACKGROUND: Approximately 25% of haemodialysis (HD) patients use catheters as vascular access. Catheter-related bloodstream infections (CRBSI) are a major risk in this population. The objective of our study was to determine whether endoluminal catheter colonization (ECC) predicts CRBSI. METHODS: We followed up a cohort of HD patients in our institution who underwent HD with tunnelled cuffed central venous catheters (TCC) between December 2006 and June 2008. Colonization of the inner catheter lumen was assessed every 15 days immediately before HD by culture of blood-heparin mixture and the time to positivity (TTP) was recorded by the BacT/Alert automated system...
March 2011: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/18209459/vascular-access-related-infections-in-hemodialysis-patients
#12
Anil K Saxena, B R Panhotra, Abdulrahman S Al-Mulhim
Hemodialysis (HD) patients are at considerably high risk for vascular access-related blood stream infections (VRBSI) that result in serious complications. Such severe infections are a great deal more frequent with central venous catheters (CVCs) and polytetrafluoroethylene (PTFE) grafts than with arteriovenous fistula (AVF). Nonetheless, the CVCs, though having "undesirable" side effects, remain "unavoidable" for the patients requiring instant dialysis access, as a consequence of the unpredictable course of chronic renal disease...
January 2005: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/16889569/enhancing-the-survival-of-tunneled-haemodialysis-catheters-using-an-antibiotic-lock-in-the-elderly-a-randomised-double-blind-clinical-trial
#13
RANDOMIZED CONTROLLED TRIAL
Anil K Saxena, Bodh R Panhotra, Dasappan S Sundaram, Mohammed Naguib Fahmy Morsy, Ali M Al-Arabi Al-Ghamdi
BACKGROUND: Tunneled-cuffed catheters (TCC) are often used among the elderly to commence and carry out haemodialysis (HD). Complications like infection and thrombosis frequently reduce the lifespan of TCC. The role of an antibiotic heparin 'lock' in the prevention of thrombotic and infectious complications and enhancement of TCC survival in the elderly has not been investigated previously. METHODS: In this prospective, double-blind clinical trial, TCC (n = 119, placed among 113 elderly patients requiring HD during March 2002 - February 2003) were randomised to either group I having TCC (n = 59, placed in 58 elderly patients) locked with cefotaxime (10 mg/mL) and heparin (5000 U/mL), or group II with TCC (n = 60, placed in 55 elderly patients) having catheter-restricted filling of heparin (5000 U/mL) alone...
August 2006: Nephrology
https://www.readbyqxmd.com/read/16358235/the-impact-of-catheter-restricted-filling-with-cefotaxime-and-heparin-on-the-lifespan-of-temporary-hemodialysis-catheters-a-case-controlled-study
#14
RANDOMIZED CONTROLLED TRIAL
Anil K Saxena, Bodh R Panhotra
BACKGROUND: Reduction in the rates of major complications such as infection and thrombosis that limit the lifespan of hemodialysis (HD) catheters could conceivably lead to improved survival of "temporary" non-tunneled HD catheters (NTCs). This study was designed to evaluate the impact of the "locking"' of a broad-spectrum antibiotic-cefotaxime with heparin, on the incidence of catheter thrombosis, catheter-related bloodstream infections (CRBSI) and the NTC lifespan. METHODS: This prospective study included 208 (109 males and 99 females) end-stage renal disease (ESRD) patients of diverse etiology enrolled for long-term HD from July 2002 to June 2003 at our tertiary care hospital...
November 2005: Journal of Nephrology
https://www.readbyqxmd.com/read/15958036/prevention-of-catheter-related-bloodstream-infections-an-appraisal-of-developments-in-designing-an-infection-resistant-dream-dialysis-catheter
#15
REVIEW
Anil K Saxena, Bodh R Panhotra
With the increasing number of elderly, diabetics and debilitated patients being accepted for haemodialysis (HD), the use of central venous catheters (CVCs) as vascular access has become more widespread, with an inevitable inherent risk of catheter-related bloodstream infections (CRBSI) and ensuing mortality. No reliable plans for the effective management of CRBSI without actually sacrificing vascular access sites are presently available. Therefore, the onus really falls on renal physicians to make effective use of the established supportive guiding principles, practices, policies and programs to prevent CRBSI among HD patients...
June 2005: Nephrology
https://www.readbyqxmd.com/read/15832231/haemodialysis-catheter-related-bloodstream-infections-current-treatment-options-and-strategies-for-prevention
#16
REVIEW
Anil K Saxena, Bodh R Panhotra
Regardless of the repeated reservations raised by countless researchers with reference to the use of catheters as vascular access for haemodialysis (HD), central venous catheters (CVCs) remain irreplaceable tools of the modern dialysis delivery system as a reliable option for the clinical situations requiring instant access to circulation, for various reasons. Patients on long-term haemodialysis are therefore at a significantly high risk for catheterrelated bloodstream infections (CRBSI) and ensuing serious complications...
March 5, 2005: Swiss Medical Weekly
https://www.readbyqxmd.com/read/15378418/catheter-related-infections-in-children-treated-with-hemodialysis
#17
REVIEW
Fabio Paglialonga, Susanna Esposito, Alberto Edefonti, Nicola Principi
Infectious complications of the central venous catheter (CVC) are a major source of morbidity among children treated with hemodialysis (HD), with catheter-related bloodstream infections (CRBSI) being the most important clinical manifestations. As only a few studies of children on HD have been published, the management of CVC-related infections in this population is mainly based on data derived from adults or occasionally from children not affected by end-stage renal disease (ESRD). The aim of this review is to discuss current knowledge concerning the epidemiology, prevention, and treatment of catheter-related infections in children on HD...
December 2004: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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