Antibiotics at the time of removal of central venous catheter to reduce morbidity and mortality in newborn infants

Abstract Background and Aims Infective endocarditis complicating chronic kidney disease is associated with high morbidity and mortality among this population particularly exposed to bacteremia.The aim of our study was to study the clinical and evolutionary features of infective endocarditis among patients with chronic renal failure. Method It is a retrospective and descriptive study including patients with chronic kidney disease hospitalized in our department, whom presented an infective endocarditis confirmed by modified DUKE criteria Results 13 patients were included aged meanly of 42.69 years [27-63 years] with a sex-ratio of 0.85. Twelve were in end stage renal disease with an average duration of dialysis of 52 months [1-180 months] and in stage 5 in one case. At the time of diagnosis, vascular access was fistula in one case and a central venous catheter in 11 cases. The catheter was simple in 3 cases and tunnelled in eight cases. The circumstances of discovery were fever in 12 cases associated with an alteration of the general state with asthenia in 10 cases. Low blood pressure was present in seven cases. At biology, the mean hemoglobin level was 8.28 g/dl [6.1-10.8 g/dl]. Leukocytosis was noted in 8 cases. Mean albuminemia was 30.61g/l [24-41g/l]. Albuminemia below 35 g/l was objectified in 6 cases. Major causative organisms were Staphylococcus species in 10 cases. Trans-thoracic echography shows vegetation in 11 cases with an average size of 17.4 mm [6-37 mm] and aortic annular abscess in 2 cases. Antibiotherapy was conducted in all cases. Complications were frequent, including congestive heart failure in 2 cases, secondary septic localisations in 3 cases, hemoptysis in one case and valve perforation in 2 cases. Five patients underwent surgery after a mean delay of 32.75 days [6-47 days]. Death occurred in 8 cases. Conclusion Infective endocarditis is severe during chronic kidney failure and more frequent among patients on dialysis by catheter. It is associated with high morbidity and mortality. Management of central venous catheter must be enhanced. Treatment must be early to improve the prognosis of this complication.

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Six Year Experience with a Structured Program to Reduce Percutaneous Central Venous Catheter Related Sepsis in Newborn Infants

Pediatric Research ◽

10.1203/00006450-199904020-00467 ◽

1999 ◽

Vol 45 (4, Part 2 of 2) ◽

pp. 78A-78A

Author(s):

Hari B Srinivasan ◽

Vanida Komatanon ◽

Jhon Patton ◽

Tonse Raju

Keyword(s):

Central Venous Catheter ◽

Newborn Infants ◽

Venous Catheter ◽

Central Venous ◽

Structured Program ◽

Percutaneous Central Venous Catheter

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Risk of Skin Necrosis Related to Injectable Vancomycin in Critically Ill Newborn Infants

10.21203/rs.3.rs-281477/v1 ◽

2021 ◽

Author(s):

Sixtine Gilliot ◽

Mohamed Riadh BOUKHRIS ◽

Morgane Masse ◽

Laurent Storme ◽

Bertrand Decaudin ◽

...

Keyword(s):

Central Venous Catheter ◽

Adverse Events ◽

Critically Ill ◽

Gestational Age ◽

Skin Necrosis ◽

Newborn Infants ◽

Venous Catheter ◽

Male Infant ◽

Central Venous ◽

Peripheral Venous Catheter

Abstract Skin necrosis caused by the administration of vancomycin via a peripheral venous catheter is rarely diagnosed. We report a case of a male infant born at 30 weeks’ gestational age who developed a skin necrosis, most probably related to vancomycin administration on a peripheral venous catheter. The frailty of this critically ill newborn probably increased its risk of exposition to adverse events. To prevent any damaging effect, the administration of vancomycin at a concentration lower than 2.5 mg/mL should be recommended when a central venous catheter is not available for the administration of injectable vancomycin in critically ill newborn.

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