P1365HEMODIALYSIS CATHETER-RELATED BLOODSTREAM INFECTIONS : A CASE SERIES

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ouni Amal ◽  
Meriem Ben salem ◽  
Malek Mojaat ◽  
Hadj Brahim Mayssa ◽  
Ben salah Manel ◽  
...  
Keyword(s):  
Case Series ◽  
Bloodstream Infections ◽  
Descriptive Study ◽  
Venous Access ◽  
University Hospital ◽  
Risk Of Infection ◽  
Hemodialysis Catheter ◽  
The Creation ◽  
Catheter Related Bloodstream Infection ◽  
Bacteriological Parameters

Abstract Background and Aims the recourse to catheter among patients on hemodialysis is frequent due to many reasons. It is highly associated to a risk of infection in comparison to AVF. The aim of our study was to determine the clinical and bacteriological parameters in patients hospitalized for dialysis catheter related bloodstream infections. Method We conducted a retrospective descriptive study based on the data of patients hospitalized for hemodialysis catheter-related bloodstream infection in the department of nephrology in Fattouma Bourguiba University hospital between January 2013 and February 2018. Data concerning the bacteriological exams were obtained from our bacteriology laboratory. Results 50 patients were included with a mean-age of 56 years old. 74% were women, 30% diabetic and 18% considered immunodepressed. The indications for the placement of catheter were: 21 patients waiting for the creation of AVF, 16 patients with a dysfunction of AVF, 6 patients with AKI and 7 patients with inadequate veins for the creation of AFV. The IJV was the site of insertion in 74% of patients (with 4 % of tunneled catheters). 26 % of patients developed a septic choc, and 74 % developed a sepsis. The culture of the specimen of catheters was positive in 32 patients (64%). Staphylococcus aureus was isolated in 14 patients (28%) with MSSA among 8 patients and enterobacteria among 8 patients. Hemoculture was only positive in 13 patients. The catheter was removed in the majority of cases except in 6 patients in whom there was no other venous access. The evolution was favourable in 80 % of patients. 5 patients developed an infective endocarditis as a secondary localization. Conclusion The AVF remains the best vascular access for hemopadialysis patients. The recourse to catheters must be considered as a last choice because of the risk of infections which frequently necessitates the hospitalization with an increase in mortality.

Prevention of Infection in Adults Receiving Intravenous Antibiotic Treatment via Indwelling Central Venous Access Devices

2019 ◽  
Vol 14 (1) ◽  
pp. 47-49
Author(s):  
Basant K. Puri ◽  
Anne Derham ◽  
Jean A. Monro
Keyword(s):  
Bloodstream Infection ◽  
Antibiotic Treatment ◽  
Central Venous Access ◽  
Case Series ◽  
Bloodstream Infections ◽  
Venous Access ◽  
Host Cells ◽  
Central Venous ◽  
Intravenous Antibiotic ◽  
Venous Access Devices

Background: The use of indwelling Central Venous Access Devices (CVADs) is associated with the development of bloodstream infections. When CVADs are used to administer systemic antibiotics, particularly second- or higher-generation cephalosporins, there is a particular risk of developing Clostridium difficile infection. The overall bloodstream infection rate is estimated to be around 1.74 per 1000 Central Venous Catheter (CVC)-days. Objective: We hypothesised that daily oral administration of the anion-binding resin colestyramine (cholestyramine) would help prevent infections in those receiving intravenous antibiotic treatment via CVADs. Method: A small case series is described of adult patients who received regular intravenous antibiotic treatment (ceftriaxone, daptomycin or vancomycin) for up to 40 weeks via indwelling CVADs; this represented a total of 357 CVC-days. In addition to following well-established strategies to prevent C. difficile infection, during the course of the intravenous antibiotic treatment the patients also received daily oral supplementation with 4 g colestyramine. Results: There were no untoward infectious events. In particular, none of the patients developed any symptoms or signs of C. difficile infection, whereas approximately one case of a bloodstream infection would have been expected. Conclusion: It is suggested that oral colestyramine supplementation may help prevent such infection through its ability to bind C. difficile toxin A (TcdA) and C. difficile toxin B (TcdB); these toxins are able to gain entry into host cells through receptor-mediated endocytosis, while anti-toxin antibody responses to TcdA and TcdB have been shown to induce protection against C. difficile infection sequelae.

scholarly journals Clinical Outcomes and Risk Factors for Tunneled Hemodialysis Catheter-Related Bloodstream Infections

2020 ◽  
Vol 7 (6) ◽  
Author(s):  
Kylie Martin ◽  
Yves S Poy Lorenzo ◽  
Po Yee Mia Leung ◽  
Sheri Chung ◽  
Emmet O’flaherty ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bloodstream Infection ◽  
Jugular Vein ◽  
Insertion Site ◽  
Bloodstream Infections ◽  
Left Internal Jugular Vein ◽  
Hemodialysis Catheter ◽  
Increased Risk ◽  
Catheter Related Bloodstream Infection ◽  
Reduced Risk

Abstract Diabetes and left internal jugular vein insertion site were significantly associated with increased risk of a catheter-related bloodstream infection from a tunneled hemodialysis catheter. Ex-smoker status was significantly associated with reduced risk.

scholarly journals Catheter-related blood stream infection in hemodialysis patients with symmetric tunneled non-side-hole hemodialysis catheters

2021 ◽  
pp. 112972982110270
Author(s):  
Michael G Tal ◽  
Alexander S Yevzlin
Keyword(s):  
Bloodstream Infection ◽  
Blood Stream Infection ◽  
Bloodstream Infections ◽  
Blood Stream ◽  
Hemodialysis Patients ◽  
Side Hole ◽  
Hemodialysis Catheter ◽  
Catheter Tip ◽  
Stage Renal Disease ◽  
Catheter Related Bloodstream Infection

Background: Tunneled hemodialysis catheter-related bloodstream infection is a major cause of morbidity and mortality in end-stage renal disease patients. Side holes positioned near the tip of catheters have been linked to formation of thrombi, which, in turn, have been implicated in predisposition to infection. In addition, side holes allow spillage of catheter locking solution, including antibiotics, thereby minimizing the lock solution’s effect on the catheter tip. This study assessed the infection events that occurred in a series of hemodialysis patients using a non-side-hole catheter. Methods: Over a period of 2 years, a novel symmetric-tip non-side-hole catheter was placed in 60 patients. Hemodialysis was performed thrice weekly. Prescribed dialyzer flows were 300–350 mL/min. Catheters were routinely locked with heparin 5000 units/mL between treatments. Patients were followed up for any catheter related complications, specifically infection events. Results: Seven events of catheter-related bloodstream infection occurred for a rate of 0.76 events per 1000 catheter-days, with the first event occurring 9 weeks after insertion. These events were treated by locking the affected catheter with 2 g of clindamycin in 2 mL of heparin 1000 units/mL and administration of intravenous antibiotics, in most cases, for 7–14 days. Two catheters were removed due to infection. Conclusions: Catheter-related bloodstream infections with non-side-hole hemodialysis catheters do occur at a relatively low rate and in this initial preliminary study it seems that most of these infections can be successfully treated without removal of the affected catheters.

CLINICAL AND PARA-CLINICAL CHARACTERISTICS OF SICK NEWBORN BABIES TREATED AT PEDIATRIC DEPARTMENT OF HUE UNIVERSITY HOSPITAL

2011 ◽  
pp. 112-117
Author(s):  
Thi Kieu Nhi Nguyen
Keyword(s):  
Respiratory Distress ◽  
Congenital Malformation ◽  
Clinical Characteristics ◽  
Descriptive Study ◽  
Neonatal Unit ◽  
University Hospital ◽  
Pediatric Department ◽  
Sick Newborn ◽  
Observational Descriptive Study

Objectives: 1. Describe neonatal classification of WHO. 2. Identify some principal clinical and paraclinical signs of term, preterm, post term babies. Patients and method: an observational descriptive study of 233 newborns hospitalized in neonatal unit at Hue university‘ s hospital was done during 12 months from 01/01/2009 to 31/12/2009 for describing neonatal classification and identifying principal clinical and paraclinical signs. Results: Premature (16.74%); Term babies (45.5%); Post term (37.76%); Premature: asphyxia (43.59%), hypothermia (25.64%), vomit (30.77%), jaundice (61.54%), congenital malformation (17.95%); CRP > 10mg/l (53.85%); anemia Hb < 15g/dl (12.82%). Term babies: poor feeding (21.7%); fever (24.53%); CRP > 10mg/l (53.77%); Hyperleucocytes/ Leucopenia (35.85%). Post term: respiratory distress (34%); lethargy (29.55%); vomit (26.14%); polycuthemia (1.14%); hypoglycemia (22.73%). Conclusion: each of neonatal type classified by WHO presente different clinical and paraclinical. Signs. The purpose of this research is to help to treat neonatal pathology more effectively.

scholarly journals P005 Rheumatology virtual clinics during COVID-19: are our patients satisfied?

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Fajer A Altamimi ◽  
Una Martin
Keyword(s):  
Medical Information ◽  
Worker Safety ◽  
University Hospital ◽  
Free Text ◽  
Risk Of Infection ◽  
Further Training ◽  
Return Envelope ◽  
The Right ◽  
Reduced Risk

Abstract Background/Aims  Telemedicine can be broadly defined as the use of telecommunication technologies to provide medical information and services. It can be audio, visual, or text. Its use has increased dramatically during the COVID-19 pandemic to ensure patient and healthcare worker safety. Any healthcare professional can engage with it. It carries benefits like reduced stress and expense of traveling, maintenance of social distancing, and reduced risk of infection. There are some potential drawbacks such as lack of physical examination, liability and technological issues. Methods  A questionnaire was sent to 200 patients, selected from different virtual clinics (new and review, doctor and ANP led) run between March and May 2020 in the rheumatology department of University Hospital Waterford. We formulated 14 questions to cover the following aspects: demography, the purpose of the consult, punctuality, feedback, medico-legal concerns, and free text for comments. A self-addressed return envelope was included. Results  83 responses were received. 2 were excluded. The ratio of females to male respondents was 59: 41, with the majority over 60 years old. The main appointment type was review 67 (83%). 80% of patients were called either before or at the time of their scheduled appointment. The vast majority (98.8%) of our patients had confidence in our data protection and trusted our system to maintain their confidentiality. 95% stated that they felt comfortable, were given enough time to explain their health problem and felt free from stress. The respondents who preferred attending the clinic in person (17 in total) compared to the virtual were mostly follow up patients- 12 vs. 5 new. Conclusion  Patient satisfaction among those surveyed was high, despite having to introduce the service abruptly during the COVID-19 pandemic. There are many improvements we can adopt to improve our service and even maintain after the pandemic as a way of communicating with our stable patients. As we are covering a large geographical catchment, we can continue to implement the virtual clinic for some appointments. We should prioritize our efforts on identifying the right patient and the type of service we can offer, further training of staff, and increasing awareness of the patients as to how to get the most out of a virtual appointment. Disclosure  F.A. Altamimi: None. U. Martin: None. C. Sheehy: None.

scholarly journals Effects of the COVID-19 Epidemic on Hospital Admissions for Non-Communicable Diseases in a Large Italian University-Hospital: A Descriptive Case-Series Study

2021 ◽  
Vol 10 (4) ◽  
pp. 880
Author(s):  
Caterina Caminiti ◽  
Giuseppe Maglietta ◽  
Tiziana Meschi ◽  
Andrea Ticinesi ◽  
Mario Silva ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Case Series ◽  
Communicable Diseases ◽  
University Hospital ◽  
Negative Consequences ◽  
Non Communicable Diseases ◽  
Case Series Study ◽  
And Gender ◽  
Long Term Impact ◽  
Series Study

Background: Concern is growing about the negative consequences that response measures to the COVID-19 epidemic may have on the management of other medical conditions. Methods: A retrospective descriptive case-series study conducted at a large University-hospital in northern Italy, an area severely hit by the epidemic. Results: Between 23 February and 14 May 2020, 4160 (52%) COVID-19 and 3778 (48%) non-COVID-19 patients were hospitalized. COVID-19 admissions peaked in the second half of March, a period characterized by an extremely high mortality rate (27.4%). The number of admissions in 2020 was similar to 2019, but COVID-19 patients gradually occupied all available beds. Comparison between COVID-19 and non-COVID-19 admissions in 2020 revealed significant differences concerning all age classes and gender. Specifically, COVID-19 patients were older, predominantly male, and exhibited more comorbidities. Overall, admissions for non-communicable diseases (NCDs) in 2020 vs. 2019 dropped by approximately one third. Statistically significant reductions were observed for acute myocardial infarction (−78, −33.9%), cerebrovascular disease (−235, −41.5%), and cancer (−368, −31.9%). While the first two appeared equally distributed between COVID-19 and non-COVID-19 patients, chronic NCDs were statistically significantly more frequent in the former, except cancer, which was less frequent in COVID-19 patients. Conclusions: Prevention of collateral damage to patients with other diseases should be an integral part of epidemic response plans. Prospective cohort studies are needed to understand the long-term impact.

Malaria among migrants in a university hospital in Colombia during 2018: A case series

2020 ◽  
pp. 004947552098130
Author(s):  
Fabián R Carreño-Almánzar ◽  
Adán Coronado-Galán ◽  
Sonia A Cala-Gómez ◽  
Agustín Vega-Vera
Keyword(s):  
Latin American ◽  
Previous History ◽  
Case Series ◽  
Cross Sectional Study ◽  
Imported Malaria ◽  
University Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
History Of ◽  
Clinical Profiles

Imported malaria has increased in Colombia since 2015 and has been attributed to migrants coming from Venezuela. We present a series of malaria cases, nested in a retrospective cross-sectional study between 2017 and 2018, aimed at calculating the prevalence of medical diseases among immigrants in a University Hospital in Colombia. Among 154 immigrants admitted for medical causes between 2017 and 2018, 8 were diagnosed with malaria, all due to Plasmodium vivax. Of these, seven had uncomplicated malaria, five had a previous history of malaria, one was critically ill, but none died. We highlight that, similar to other case series of imported malaria, Latin American migrants were young, with similar clinical profiles, having a low proportion of severe cases, and P. vivax was the most frequent cause.

scholarly journals Totally implantable catheter embolism: two related cases

2008 ◽  
Vol 126 (6) ◽  
pp. 347-349 ◽  
Author(s):  
Rodrigo Chaves Ribeiro ◽  
Áurea Cristina Ferreira Monteiro ◽  
Quirino Cavalcante Menezes ◽  
Sérgio Tomaz Schettini ◽  
Sonia Maria Rossi Vianna
Keyword(s):  
Wilms Tumor ◽  
Rare Complication ◽  
Case Series ◽  
Stage Iv ◽  
Venous Access ◽  
Endovascular Procedure ◽  
Asymptomatic Patients ◽  
Case Series Study ◽  
Series Study

CONTEXT AND OBJECTIVE: Long-term totally implantable catheters (e.g. Port-a-Cath®) are frequently used for long-term venous access in children with cancer. The use of this type of catheter is associated with complications such as infection, extrusion, extravasation and thrombosis. Embolism of catheter fragments is a rare complication, but has potential for morbidity. The aim here was to report on two cases in which embolism of fragments of a long-term totally implantable catheter occurred. DESIGN AND SETTING: Case series study at Hospital do Servidor Público Estadual, São Paulo. METHODS: Retrospective review of catheter embolism in oncological pediatric patients with long-term totally implantable catheters. RESULTS: The first patient was a 3-year-old girl diagnosed with stage IV Wilms' tumor. Treatment was started with the introduction of a totally implantable catheter through the subclavian vein. At the time of removal, it was realized that the catheter had fractured inside the heart. An endovascular procedure was necessary to remove the fragment. The second case was a boy diagnosed with stage II Wilms' tumor at the age of two years. At the time of removal, it was noticed that the catheter had disconnected from the reservoir and an endovascular procedure was also necessary to remove the embolized catheter. CONCLUSION: Embolism of fragments of totally implantable catheters is a rare complication that needs to be recognized even in asymptomatic patients.

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