Infectious Peritonitis. The Main Complication of Intermittent Peritoneal Dialysis

1981 ◽  
Vol 4 (6) ◽  
pp. 281-285 ◽  
Author(s):  
K.E. Hemmeløff Andersen ◽  
H.J. Kolmos

Infectious peritonitis was studied in 164 patients with renal failure receiving 24, 282 peritoneal dialyses over a five-year period. One hundred and fifty nine episodes were registered in 93 patients. The overall incidence was 0.66 episodes per 100 dialyses. Two epidemics accounted for a higher incidence during the first half of the study, while the incidence of endemic peritonitis remained unchanged. Infectious peritonitis was the most common complication among out-patients and was the cause of drop out in 39 per cent of the patients transferred to haemodialysis. The calculated mortality from peritonitis was 0.08, corresponding to one fifth of all deaths. The case fatality rate was 0.14. The most common aetiological microorganisms were Staphylococcus aureus and micrococci, accounting for 50 per cent of the cases. Forty six per cent of the cases caused by Staphylococcus aureus were preceeded by wound or catheter tunnel infections with the same strain. This points to the abdominal skin flora as the main source of endemic peritonitis. However, further epidemiological studies are needed to elucidate how the skin saprophytes reach the peritoneal cavity.

Author(s):  
Isabel Guthridge ◽  
Simon Smith ◽  
Matthew Law ◽  
Enzo Binotto ◽  
Josh Hanson

Background: Methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia has a high case-fatality rate, but currently recommended antimicrobial therapies have many shortcomings. The efficacy and safety of lincosamide therapy for MRSA bacteraemia is incompletely defined. Materials and methods: A retrospective audit of the management of all adults with MRSA bacteraemia at an Australian tertiary-referral hospital between 1 January 2007 and 31 December 2020. Results: 176 patients were included. The case-fatality rate declined from 14/57 (25%) in the first half of the study to 12/119 (10%) in the second half (p=0.01). Of the 172 patients receiving antibiotics, 62 (36%) received a lincosamide-predominant regimen (lincosamide monotherapy for >50% of the intravenous course). The patients receiving lincosamide-predominant intravenous therapy had lower in-hospital mortality (odds ratio (OR): 0.07 (95% confidence interval (CI): 0.01-0.53), p=0.01) and a lower incidence of renal complications (OR (95% CI): 0.34 (0.15-0.75), p=0.008) than patients receiving an alternative regimen. In multivariate analysis that also considered age, disease severity, comorbidity, infectious diseases consultation, source control and the year of admission, patients receiving a lincosamide-predominant regimen were still less likely to die in hospital than those receiving an alternative regimen (OR (95% CI): 0.05 (0.00-0.65), p=0.02). Conclusions: Lincosamides appear to have utility - at least as stepdown therapy - in the treatment of MRSA bacteremia, particularly in young, clinically stable patients with few comorbidities in whom endocarditis has been excluded. Prospective studies will help define their optimal role.


Antibiotics ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 338
Author(s):  
Grzegorz Ziółkowski ◽  
Iwona Pawłowska ◽  
Estera Jachowicz ◽  
Michał Stasiowski

Some of the most serious healthcare-associated infections (HAI) are highly deadly bloodstream infections (BSIs) caused by Staphylococcus aureus. The aim of the study was to analyse compliance of treatment practice with clinical guidelines in patients with S. aureus BSIs. The study was conducted at the Sosnowiec Hospital, Poland in 2019. During the study, 29,747 patients were hospitalized and 41 S. aureus BSIs (only HAIs) episodes were observed. According to local clinical practice guidelines, each case of BSI required blood cultures, echocardiography and control culture after the implementation of the targeted therapy. Incidence rate of S. aureus BSI was 0.8/1000 admissions; the greatest department admission rates were in the ICU (19.3/1000 admissions) and in the Nephrology Department (8.7/1000 admissions). Only 2 patients were treated following the protocol (4.8%); the most common errors were the use of an inappropriate drug or incorrect duration of antibiotic treatment. No patient underwent echocardiography, and control cultures were performed in 70% of cases. The case fatality rate was 7.3%. A satisfactorily low case fatality rate was found despite the poor antibiotic stewardship. Lack of discipline concerning antibiotic use can strongly impact the observed high drug resistance in HAIs and high Clostridioides difficile incidence rate in the studied hospital.


2019 ◽  
Vol 2 (1) ◽  
pp. 12-16
Author(s):  
Yola Violita Agustin ◽  
Noor Andryan Ilsan ◽  
Maulin Inggraini

Pendahuluan: Makanan dan minuman yang tidak memenuhi persyaratan kesehatan jika dikonsumsi  akan menimbulkan gangguan kesehatan seperti diare, kolera, disentri, demam tifoid dan keracunan makanan. Menurut data Kemenkes tahun 2017 kasus diare pada tahun 2016 dengan Case Fatality Rate (CFR) mencapai 3.04% dengan 6 orang meninggal dari 198 kasus. Kebersihan peralatan makan merupakan salah satu aspek dalam hygiene dan sanitasi makanan. Proses pencucian peralatan makan yang benar akan berdampak pada hygiene dan sanitasi yang baik. Spons cuci piring umumnya digunakan untuk menghilangkan sisa makanan. Sisa makanan yang terdapat pada spons akan mendukung lingkungan bakteri untuk tumbuh. Spons yang terkontaminasi dapat mengkontaminasi peralatan makan, sehingga menyebabkan penularan penyakit bawaan makanan. Studi kasus di Amerika Serikat menunjukkan bahwa terjadi hampir 38.6 juta kasus penyakit akibat penyebaran penyakit bawaan makanan. Penelitian ini bertujuan untuk mengetahui keberadaan bakteri patogen serta jenis bakteri patogen yang terdapat pada spons cuci piring pada penjual makanan. Metode: Identifikasi bakteri patogen dilakukan pada 10 spons cuci piring yang digunakan penjual makanan di Pasar Margahayu. Identifikasi bakteri menggunakan pewarnaan Gram dan uji biokimia. Hasil: Jenis bakteri patogen yang teridentifikasi adalah Escherichia coli, Staphylococcus aureus, Pseudomonas aeroginosa, Enterobacter aerogenes, dan Proteus sp. Persentase isolat yang ditemukan adalah 80% spons mengandung S. aureus, 70% mengandung E. aerogenes, 20% mengandung E.coli, 20% mengandung P.aeroginosa, dan 10% mengandung Proteus sp. Kesimpulan: sampel spons cuci piring yang telah dilakukan pewarnaan Gram dan uji biokimia menunjukkan kecurigaan terhadap koloni berwarna putih transparan adalah Proteus sp. koloni putih transparan bulat kecil adalah Enterobacter aerogenes, putih bulat besar adalah Escherichia coli, putih bulat kecil adalah Pseudomonas aeroginosa, koloni merah pada media SSA adalah Enterobacter aerogenes, dan koloni putih dengan zona kuning adalah Staphylococcus aureus.


2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Aliae A. R. Mohamed Hussein ◽  
Marwa Rashad Salem ◽  
Samar Salman ◽  
A F Abdulrahim ◽  
Nasrallah A. Al Massry ◽  
...  

Abstract Background The observations of some recent epidemiological studies offer hope for a reduced impact of COVID-19 for countries which practice universal BCG vaccination policy. Main body This report provides a correlation between the case fatality rates of COVID-19 and the percentage of BCG vaccination coverage in 183 most affected countries. The main objective of this observational ecologic report is to evaluate possible effects of the previous BCG vaccination in different populations and the epidemic outcomes specially the rates of severe/critical cases and case fatalities. The analysis is preliminary since it is based on constantly rolling data while the COVID-19 pandemic is still unfolding. Conclusion Our findings seem to support the fact that an older BCG vaccine may have a protective role in avoiding severe/critical SARS-CoV2 pneumonia and relatively decrease its fatalities.


Author(s):  
Nur Sabiq Assadah ◽  
I Sendow ◽  
NLP I Dharmayanti

<p class="awabstrak2"><em>Hantavirus</em> is a zoonosis transmitted by rodents and have been spread in various countries. <em>Hantavirus</em> causes <em>Hantavirus</em> Pulmonary Syndrome (HPS) and Haemorrhagic Fever with Renal Syndrome (HFRS) in humans is still receiving worldwide attention due to the high case fatality rate. Epidemiological studies have shown that <em>Hantavirus</em> is widespread globally, including in Indonesia. Indonesia is an archipelago and has a tropical climate, and is crossed by the equator so that it has an enormous diversity of animals, including those that become reservoirs of <em>Hantavirus</em> and other vulnerable animals. The high risk of developing <em>Hantavirus</em> in Indonesia does not rule out the possibility of a <em>Hantavirus</em> outbreak if no preventive action is taken. Until now there is no effective and safe vaccine or treatment for <em>Hantavirus</em>. Various development efforts continue to be made to obtain an appropriate and safe vaccine to prevent and stop the spread of <em>Hantavirus</em>. This paper discusses <em>Hantavirus</em>, including its structure and mechanism of transmission, the current situation of <em>Hantavirus</em> in Indonesia and the efforts that can be made to prevent <em>Hantavirus</em>, including the development of vaccines and their drugs.</p>


2021 ◽  
Vol 10 (05) ◽  
pp. 5-13
Author(s):  
Şeyda Tələt qızı Şixəliyeva ◽  
◽  
Marina Rüstəm qızı İsmayıl ◽  
Ramilə Əkbər qızı Hacıyeva ◽  
Şəfəq Yolçu qızı Mustafayeva ◽  
...  

There have been three fatal coronavirus-related pandemics in the twenty-first century: SARS (2002), MERS (2012), and COVID-19(2019). COVID19 first appeared in Wuhan, China, in December 2019 and quickly spread worldwide. COVID-19 is a transmissible viral infection that is caused by SARS-CoV-2, a severe acute respiratory syndrome coronavirus 2. Epidemiological studies conducted in many countries of the world are aimed at identifying the presence of dependence of morbidity and mortality on various factors. Some of these factors are the age, sex, race or ethnicity of the patients. Analysis of published studies has revealed a significant correlation between age, gender, and ethnicity factors and the severity of the course and mortality from COVID-19, which may further contribute to the development of alternative strategic approaches to solve the global problem of coronavirus infection-SARS-CoV-2. Key words: coronavirus, COVID 19, age qroup, case fatality rate, gender, race, ethnicity


2020 ◽  
Author(s):  
Ahmed Youssef Kada

BACKGROUND Covid-19 is an emerging infectious disease like viral zoonosis caused by new coronavirus SARS CoV 2. On December 31, 2019, Wuhan Municipal Health Commission in Hubei province (China) reported cases of pneumonia, the origin of which is a new coronavirus. Rapidly extendable around the world, the World Health Organization (WHO) declares it pandemic on March 11, 2020. This pandemic reaches Algeria on February 25, 2020, date on which the Algerian minister of health, announced the first case of Covid-19, a foreign citizen. From March 1, a cluster is formed in Blida and becomes the epicentre of the coronavirus epidemic in Algeria, its total quarantine is established on March 24, 2020, it will be smoothly alleviated on April 24. A therapeutic protocol based on hydroxychloroquine and azithromycin was put in place on March 23, for complicated cases, it was extended to all the cases confirmed on April 06. OBJECTIVE This study aimed to demonstrate the effectiveness of hydroxychloroquin/azithromycin protocol in Algeria, in particular after its extension to all patients diagnosed COVID-19 positive on RT-PCR test. We were able to illustrate this fact graphically, but not to prove it statistically because the design of our study, indeed in the 7 days which followed generalization of therapeutic protocol, case fatality rate decrease and doubling time increase, thus confirming the impact of wide and early prescription of hydroxychloroquin/azithromycin protocol. METHODS We have analyzed the data collected from press releases and follow-ups published daily by the Ministry of Health, we have studied the possible correlations of these data with certain events or decisions having a possible impact on their development, such as confinement at home and its reduction, the prescription of hydroxychloroquine/azithromycin combination for serious patients and its extension to all positive COVID subjects. Results are presented in graphics, the data collection was closed on 31/05/2020. RESULTS Covid-19 pandemic spreads from February 25, 2020, when a foreign citizen is tested positive, on March 1 a cluster is formed in the city of Blida where sixteen members of the same family are infected during a wedding party. Wilaya of Blida becomes the epicentre of coronavirus epidemic in Algeria and lockdown measures taken, while the number of national cases diagnosed begins to increases In any event, the association of early containment measures combined with a generalized initial treatment for all positive cases, whatever their degree of severity, will have contributed to a reduction in the fatality rate of COVID 19 and a slowing down of its doubling time. CONCLUSIONS In Algeria, the rapid combination of rigorous containment measure at home and early generalized treatment with hydroxychloroquin have demonstrated their effectiveness in terms of morbidity and mortality, the classic measures of social distancing and hygiene will make it possible to perpetuate these results by reducing viral transmission, the only unknown, the reopening procedure which can only be started after being surrounded by precautions aimed at ensuring the understanding of the population. CLINICALTRIAL Algeria, Covid-19, pandemic, hydroxychloroquin, azithromycin, case fatality rate


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Lei-Ke Zhang ◽  
Yuan Sun ◽  
Haolong Zeng ◽  
Qingxing Wang ◽  
Xiaming Jiang ◽  
...  

A Correction to this paper has been published: https://doi.org/10.1038/s41421-021-00267-0


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