Dynamics of Hemodialysis Catheter Colonization by Coagulase-Negative Staphylococci

2005 ◽  
Vol 26 (6) ◽  
pp. 567-574 ◽  
Author(s):  
Christoph A. Fux ◽  
Dominik Uehlinger ◽  
Thomas Bodmer ◽  
Sara Droz ◽  
Claudine Zellweger ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
University Hospital ◽  
Microbiological Analysis ◽  
Catheter Colonization ◽  
Coagulase Negative Staphylococci ◽  
Prospective Longitudinal Study ◽  
Hemodialysis Catheter ◽  
Hemodialysis Unit ◽  
Colonization Dynamics ◽  
Prospective Longitudinal

AbstractObjectives:Catheter colonization is a necessary but poorly characterized step in the pathogenesis of catheter-related infections. Colonization dynamics of central venous hemodialysis catheters were studied with emphasis on coagulase-negative staphylococci (CoNS) and their population genetics, antibiotic resistance, and biofilm formation. The homogeneity of CoNS colony morphotypes was evaluated.Design:Prospective, longitudinal study during 1,158 catheter-days with microbiological analysis of skin swabs, weekly catheter blood and brush samples, and catheter tips.Setting:Hemodialysis unit of a university hospital.Patients:Twenty-six patients with 24 non-tunneled and 5 tunneled catheters.Results:Nineteen (65.5%) of the catheters became colonized, 17 by CoNS. CoNS colonization of the inner lumen was observed in 17.2% of the catheters and was first detectable after 3 weeks. Colonization of the outer surface occurred in 44.8% of the catheters within a minimum of 2 weeks. PFGE of 53 CoNS revealed 10 clones and 20 unique isolates. Isolates from clones were more frequent in catheter blood and brush cultures than were unique isolates (41% vs 15%), were resistant to more antibiotics (median, 7 vs 2), and tended to more often carry theicaAgene (64.1% vs 40%). Four (23.5%) of the catheters showed colonization with a mixture of CoNS based on PFGE. The time from catheter insertion to such mixed CoNS colonization was longer than that for colonization with one CoNS PFGE pattern only (42 vs 25 days).Conclusions:Colonization of hemodialysis catheters is dominated by multidrug-resistant,icaA-positive CoNS clones. Mixed CoNS colonization occurs, but is delayed, suggesting a process of sequential superinfection (Infect Control Hosp Epidemiol2005;26:567-574).

scholarly journals Longitudinal Study of Effect of Hotz's Plate and Lip Adhesion on Maxillary Growth in Bilateral Cleft Lip and Palate Patients

2012 ◽  
Vol 49 (2) ◽  
pp. 230-236 ◽  
Author(s):  
Muhammad Syafrudin Hak ◽  
Masaaki Sasaguri ◽  
Farida Kamil Sulaiman ◽  
Enny Tyasandarwati Hardono ◽  
Akira Suzuki ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Maxillofacial Surgery ◽  
University Hospital ◽  
Dental Arch ◽  
Prospective Longitudinal Study ◽  
Bilateral Cleft Lip ◽  
Maxillary Growth ◽  
Prospective Longitudinal

Objective To investigate the effects of infant orthopedic treatment and lip adhesion on maxillary growth of patients with bilateral cleft lip and palate (BCLP). Design Prospective longitudinal study. Setting The present study was conducted at the Cleft Lip and Palate Center, Harapan Kita Children and Maternity Hospital, Indonesia, and the Department of Oral and Maxillofacial Surgery, Kyushu University Hospital, Japan. Subjects The study sample consisted of 53 patients with complete BCLP and 10 noncleft patients with other diseases. Patients with BCLP were divided into three groups: H (-), 11 patients treated without Hotz's plate; H (+), 24 treated with Hotz's plate; and LA-H, 18 treated with lip adhesion and Hotz's plate. Methods Serial dental casts were obtained from each BCLP child at the following four time points: first visit, labioplasty, palatoplasty, and 5 years of age. Each maxillary dental cast was scanned, and the linear and angular dimensions were measured. Results and Conclusion Lip adhesion showed a temporary negative effect. In all patients with BCLP, the surgeries affected the growth of the anterior arch width until the age of 5 years. Collapse of the premaxilla following labioplasty in the H (-) group affected the growth of dental arch length until the age of 5 years. Treatment using Hotz's plate prevented collapse of the premaxilla, and the growth of the arch length was comparable to that observed in the noncleft group.

Can Occlusal Evaluation of Children with Unilateral Cleft Lip and Palate Help Determine Future Maxillofacial Morphology?

2014 ◽  
Vol 51 (6) ◽  
pp. 696-706 ◽  
Author(s):  
Akira Suzuki ◽  
Masaaki Sasaguri ◽  
Kenji Hiura ◽  
Atsushi Yasunaga ◽  
Takeshi Mitsuyasu ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Rank Order ◽  
University Hospital ◽  
Dental Arch ◽  
Prospective Longitudinal Study ◽  
Lateral Cephalograms ◽  
Prospective Longitudinal ◽  
The Relationship ◽  
Dental Cast

Objective To investigate the change in occlusal evaluations from the 5-year-olds' index to the Goslon Yardstick and to compare the relationship between the evaluations and maxillofacial growth in patients with complete unilateral cleft lip and palate (UCLP). Design A prospective longitudinal study. Subjects The sample consisted of 85 patients with complete UCLP who underwent surgery from 1969 to 1994 and were treated at the Kyushu University Hospital in Fukuoka, Japan. Subjects had two serial dental casts performed at the ages of 5 and 10 years. Furthermore, each patient had lateral cephalographs taken at the age of 5 years, 76 of 85 subjects had films taken at the age of 10 years, and 54 subjects also had lateral cephalograms taken after the age of 15 years. Methods Every dental cast was evaluated by the 5-year-olds' index and the Goslon Yardstick, respectively. The lateral cephalographs were traced and digitized, and angular dimensions were calculated. Outcomes were compared using Spearman's rank-order correlation analysis and the Kruskal-Wallis analysis. Results and Conclusion Dental arch relationships were evaluated and rated as 2.96 in the 5-year-olds' index and 2.85 in the Goslon Yardstick, respectively. Both groupings showed a significant relationship, and they showed no change in 36 out of 85 subjects (42.3%), significant improvement in 30 (35.3%), and deterioration in 19 (22.3%). Two occlusal groupings and maxillofacial morphology on the cephalographs indicated that the grouping reflected the anteroposterior position of the mandible. Moreover, both groupings showed some relation to previous maxillofacial growth, but they did not show any relationship with future growth. The Goslon Yardstick may not predict maxillofacial morphology in adulthood.

scholarly journals Bacteriological profile and antimicrobial susceptibility pattern of endotracheal tube secretion of patients in ICUs of a tertiary care hospital in Punjab

2021 ◽  
Vol 8 (3) ◽  
pp. 224-229
Author(s):  
Kiranjeet Kaur ◽  
Shavetika Jindal
Keyword(s):  
Antimicrobial Susceptibility ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Care Hospital ◽  
Susceptibility Pattern ◽  
Prospective Longitudinal Study ◽  
Antimicrobial Susceptibility Pattern ◽  
Prospective Longitudinal

Healthcare associated pneumonia (HAP)is second most common HCAIs that occur in 27% critically ill patients. Eighty-six percent of HAP are associated with mechanical ventilation and termed as ventilator associated pneumonia (VAP). VAP due to multidrug resistant has also increased in recent past. To isolate and identify the bacterial pathogens in endotracheal tubes aspirates of ICUs patients and study their antimicrobial susceptibility pattern.A prospective longitudinal study was conducted in the Microbiology laboratory of a tertiary care hospital over a period of six months after clearance from institutional Research Committee and Ethical Committee. All the samples of ETT secretions received in Clinical Microbiology lab from ICU patients and fulfilling the criteria for VAP were included in this study. Samples were processed as per standard protocol and organisms were identified on the basis of gram staining, colony characters and biochemical tests. Antibiotic sensitivity was performed by Kirby Bauer disc diffusion method as per CLSI guidelines. : A total of 100 samples of ET secretions were collected and proceeded for culture. Out of 100 samples, 76 (76.0%) were positive for bacterial growth. Among 76 positive cultures, a total 80 bacterial isolates were obtained as some cultures were showing polymicrobial growth. Five (6.26%) isolates were Gram Positive bacteria and 75(93.7%) were Gram negative. The most frequent isolates were 35(43.7%) followed by , isolates were sensitive to colistin while resistant to ampicillin and amoxiclav. isolates were sensitive to colistin and resistant to ampicillin, amoxiclav, ciprofloxacin, cefixime, piperacillin tazobactam. isolates were sensitive to colistin while resistant to ampicillin, amoxiclav, ceftizidime and piperacillin tazobactam. In our study antimicrobial pattern of isolated bacteria shows multidrug resistant pathogens which are associated with VAP and limit therapeutic options.

scholarly journals Haemoconcentration risk at the end of pregnancy: effects on neonatal behaviour

2017 ◽  
Vol 20 (8) ◽  
pp. 1405-1413 ◽  
Author(s):  
Nuria Aranda ◽  
Carmen Hernández-Martínez ◽  
Victoria Arija ◽  
Blanca Ribot ◽  
Josefa Canals
Keyword(s):  
Pregnant Women ◽  
Self Regulation ◽  
Clinical History ◽  
Normal Weight ◽  
State Regulation ◽  
University Hospital ◽  
Third Trimester ◽  
Prospective Longitudinal Study ◽  
The Third ◽  
Prospective Longitudinal

AbstractObjectiveTo determine the associations between haemoconcentration at the end of pregnancy (third trimester and delivery) and neonatal behaviour in healthy pregnant women supplemented with moderate doses of Fe.DesignA prospective longitudinal study in which obstetric and clinical history, maternal toxic habits, maternal anxiety and Hb levels were recorded at the third trimester and delivery. Neonatal behaviour was assessed at 48–72 h of age using the Neonatal Behavioral Assessment Scale.SettingUnit of Obstetrics and Gynaecology of the Sant Joan University Hospital in Reus, Tarragona (Spain).SubjectsA total of 210 healthy and well-nourished pregnant women and their full-term, normal-weight newborns.ResultsThe results showed that, after adjusting for confounders, in the third trimester the risk of haemoconcentration (6·2 % of pregnant women) was related to decreased neonatal state regulation (B=−1·273, P=0·006) and alertness (B=−1·848, P=0·006) scores. In addition, the risk of haemoconcentration at delivery (12·0 % of pregnant women) was also related to decreased neonatal state regulation (B=−0·796, P=0·021) and poor robustness and endurance (B=−0·921, P=0·005) scores.ConclusionsOur results show that the risk of haemoconcentration at the end of pregnancy is related to the neonate’s neurodevelopment (and self-regulation capabilities), suggesting that Fe supplementation patterns and maternal Fe status during pregnancy are important factors for neurodevelopment which may be carefully controlled.

scholarly journals Identification and medical importance of coagulase-negative staphylococci species

1999 ◽  
Vol 117 (4) ◽  
pp. 175-178 ◽  
Author(s):  
Elaine Cristina Manini Minto ◽  
Cristiane Barelli ◽  
Roberto Martinez ◽  
Ana Lúcia da Costa Darini
Keyword(s):  
Staphylococcus Epidermidis ◽  
Antimicrobial Agents ◽  
University Hospital ◽  
Intravenous Catheter ◽  
Catheter Colonization ◽  
Coagulase Negative Staphylococci ◽  
Blood Samples ◽  
Medical Importance ◽  
The University ◽  
Intravenous Catheters

A total of 126 coagulase-negative staphylococci strains (CNS) were isolated from blood samples and from the intravenous catheters and cerebrospinal fluid of 103 patients admitted to the University Hospital of Ribeirão Preto. Staphylococcus epidermidis (68.2%), S. haemolyticus (11.1%) and S. hominis (3.2%) were the most frequent species. The last two CNS showed greater resistance to antimicrobial agents than S. epidermidis. CNS were the agents of infection in 10.7% of the patients and the agents of intravenous catheter colonization in 18.4% of the cases.

scholarly journals Prospective Longitudinal Serosurvey of Health Care Workers in the First Wave of the SARS-CoV-2 Pandemic in a Quaternary Care Hospital in Munich, Germany

2021 ◽  
Author(s):  
Tobias Weinberger ◽  
Julius Steffen ◽  
Andreas Osterman ◽  
Tonina T Mueller ◽  
Maximilian Muenchhoff ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Health Care Workers ◽  
University Hospital ◽  
Health Care Personnel ◽  
Care Hospital ◽  
Prospective Longitudinal Study ◽  
Care Workers ◽  
Antibody Assays ◽  
Prospective Longitudinal

Abstract Background High infection rates among health care personnel in an uncontained pandemic can paralyze health systems due to staff shortages. Risk constellations and rates of seroconversion for health care workers during the first wave of the SARS-CoV-2 pandemic are still largely unclear. Methods Health care personnel (n=300) on different organizational units in the LMU Munich University Hospital were included and followed in this prospective longitudinal study in the period of March 24 until July 7, 2020. Participants were monitored in intervals of two to six weeks using different antibody assays for serological testing and questionnaires to evaluate risk contacts. In a subgroup of infected participants, we obtained nasopharyngeal swabs to perform whole genome sequencing for outbreak characterization. Results Health care workers involved in patient care on dedicated COVID-19 wards or on regular non-COVID-19 wards showed a higher rate of SARS-CoV-2 seroconversion compared to staff in the emergency department and non-frontline personnel. The landscape of risk contacts in these units was dynamic, with a decrease of unprotected risk contacts in the emergency department and an increase on non-COVID-19 wards. Both, the intensity and number of risk contacts, were associated with higher rates of seroconversion. On regular wards, staff infections tended to occur in clusters, while infections on COVID-19 wards were less frequent and apparently independent of each other. Conclusion The risk of SARS-CoV-2 infection for front-line health care workers was increased during the first pandemic wave in Southern Germany. Stringent measures for infection control are essential to protect all patient-facing staff during the ongoing pandemic.

Effects of Cheiloplasty on Maxillary Dental Arch Development in Infants with Unilateral Complete Cleft Lip and Palate

2002 ◽  
Vol 39 (5) ◽  
pp. 513-516 ◽  
Author(s):  
Chiung-Shing Huang ◽  
Wein-I Wang ◽  
Eric Jein-Wein Liou ◽  
Yu-Ray Chen ◽  
Philip Kao-Ting Chen ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
University Hospital ◽  
Dental Arch ◽  
Anterior Portion ◽  
Prospective Longitudinal Study ◽  
Anterior Arch ◽  
Before And After ◽  
Prospective Longitudinal ◽  
Rotation Advancement

Objective: To identify and analyze quantitatively the development of the maxillary dental arch before and after cheiloplasty. Design: Prospective, longitudinal study of maxillary dental arch development at age of 1, 3, 6, and 12 months. Setting: All patients were treated at a university hospital craniofacial center. Patients: Twenty-seven infants with nonsyndromic, unilateral complete cleft lip and palate. Intervention: Millard's rotation-advancement cheiloplasty was performed between the ages of 3 and 4 months. Results: The anterior portion of the nonclefted segment (I-G), anterior ridge length of the nonclefted segment (I-C), and anterior ridge length of the clefted segment (L-C′) continuously increased from 1 to 12 months of age. The anterior cleft width (G-L), anterior arch depth (I⊥CC), anterior basal angle (∠GC-CC′), and anterior arch curature angle (∠GIC) continuously decreased after the cheiloplasty. Conclusions: Cheiloplasty could mold the anterior portion of the maxillary dental arch palatally by exerting continuous pressure.

Hemodialysis Catheter-Related Sepsis

2017 ◽  
Vol 2 (2) ◽  
Keyword(s):  
Septic Shock ◽  
Cardiovascular Complications ◽  
Infectious Complications ◽  
University Hospital ◽  
Coagulase Negative Staphylococci ◽  
Hemodialysis Catheter ◽  
Candida Sp ◽  
One Year ◽  
Hospital Center

Introduction: Hemodialysis (HD) patients are exposed to various complications. Infectious complications are the second leading cause of morbidity and mortality after cardiovascular complications. The aim of our study is to describe the clinical, paraclinical and bacteriological aspects of the HD catheter-related infection. Patients and methods: We carried out a retrospective study over a period of one year, involving 25 HDs patients hospitalized in the Department of Infectious Diseases, Cardiology and Nephrology of Ibn Rochd University Hospital Center in Casablanca. Results: The majority of these patients were male (72%) with an average age of 59 years. Twenty patients had a jugular catheter. Fever was the main symptom found in all patients, associated with sepsis signs in 88% of cases, while 12% of patients were classified as a septic shock. All patients had a biological infectious syndrome with leukocytosis and positive CRP. Peripheral and catheter-based blood cultures, and culture of the distal tip of the catheter were performed in all patients., allowing the determination of the causative germ in 72% of the cases. The most frequently isolated germs were Staphylococcus aureus (66.7%), Gram-negative bacilli (16.7%), coagulase-negative staphylococci (11.1%), and Candida sp (5.5%). All patients received a probabilistic antibiotherapy based on vancomycin and amikacin combination adapted to the renal function andthe antibiogram results thereafter. Six patients had associated endocarditis. The evolution was favourable in 76% of the patients. Six patients died. The main cause of death is the septic shock (3 cases). Conclusion: Vascular access in HD deserves special attention. The prevention of infectious complications in this category is based on compliance with hygiene rules and the temporary use of catheters and then the creation of native arteriovenous fistula.

The Longitudinal Effect of a Single Peritonitis Episode on Peritoneal Membrane Transport in CAPD Patients

2000 ◽  
Vol 20 (2) ◽  
pp. 220-226 ◽  
Author(s):  
Kenan Ates ◽  
Rafet Koç ◽  
Gökhan Nergizoglu ◽  
Sehsuvar Ertürk ◽  
Kenan Keven ◽  
...  
Keyword(s):  
Solute Transport ◽  
Membrane Transport ◽  
Regression Line ◽  
University Hospital ◽  
Logarithmic Scale ◽  
Peritoneal Membrane ◽  
Prospective Longitudinal Study ◽  
Glucose Ratio ◽  
Prospective Longitudinal

Objective To evaluate the longitudinal effect of a single peritonitis episode on peritoneal membrane transport. Design A prospective longitudinal study. Setting Department of nephrology in a university hospital. Patients Eighteen continuous ambulatory peritoneal dialysis patients with peritonitis. Methods Peritoneal transport for low, middle, and high molecular weight (MW) solutes was evaluated by peritoneal equilibration test (PET). The first PET was performed on the day following the diagnosis of peritonitis. The test was repeated at weeks 1, 2, 4, 12, and 24 and the results were compared to baseline PET data obtained before peritonitis. In addition, dialysate CA125 concentration and leukocyte count were measured. Results During peritonitis there were significant increases in dialysate-to-plasma (D/P) ratios for all low, middle, and high MW solutes except potassium, and decreases in D4/D0 glucose ratio and ultrafiltration (UF) volume. Over the subsequent 2 weeks, solute transport gradually decreased to the baseline values then remained unchanged during follow-up. Although net UF volume demonstrated a similar course during the study, it did not completely return to the baseline value. No decrease in D/P sodium ratio was found at 60 minutes during the PET performed 24 weeks after peritonitis. The percent change in solute transport during peritonitis compared to baseline value was significantly correlated with a solute's MW ( r = 0.776, p = 0.014). The slope of the regression line for D/P ratios versus MW, in double logarithmic scale, before peritonitis (-0.73 ± 0.09) was steeper than the slope during peritonitis (-0.59 ± 0.08). Conclusions These findings indicate that a single peritonitis episode does not permanently affect peritoneal solute transport. However, the loss of net UF that accompanies peritonitis is not completely recovered, probably due to impairment of transcellular water transport. The transport changes associated with peritonitis may be due to the combined effect of increased effective peritoneal surface area and intrinsic permeability. Our findings suggest that the latter mechanism seems to be more important.

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