Bacterial Load Associated With Tunneled Dialysis Catheters in Symptom-Free Hemodialysis Patients

2021 ◽  
pp. 153857442110482
Author(s):  
Davut Azboy ◽  
Zeki Temiztürk ◽  
Fevzi Sarper Türker
Keyword(s):  
Bacterial Growth ◽  
Bacterial Load ◽  
Asymptomatic Infection ◽  
Hemodialysis Patients ◽  
Number Of Patients ◽  
Prolonged Duration ◽  
Catheter Tip ◽  
The Right ◽  
And Staphylococcus Aureus ◽  
Significant Factors

Objective This study aimed to evaluate the rate of asymptomatic bacterial infection of tunneled dialysis catheters (TDCs) removed due to maturation of native arteriovenous fistula (nAVF) or catheter dysfunction in hemodialysis patients with no clinically apparent infection. Materials and Methods A total of 229 patients (43.2% [n = 99] female and 56.8% [n = 130] male), who underwent hemodialysis through a TDC, were included in this study. Tip cultures of TDCs removed in an operating room and under sterile conditions were collected. All patients were asymptomatic for catheter infection and had not received antibiotic therapy for the last month. Results The median duration of catheterization was 80 days (min: 5, max: 2880). Bacterial growth was observed in a total of 62 (27.1%) patients. The most common microorganisms were Staphylococcus epidermidis and Staphylococcus aureus. The asymptomatic infection rate was highest in catheters placed through the right and left subclavian veins; however, this was not statistically significant due to the small number of patients. Placement and usage time of TDCs were found to be the most significant factors for bacterial growth in the catheter tip culture ( P < .001). Conclusion Prolonged duration and use of the catheter is significant in terms of bacterial load. The use of TDC as vascular access in renal replacement therapy should be avoided as much as possible.

scholarly journals Bactericidal Activity of Ready-To-Use Alcohol-Based Commercial Wipes According to EN 16615 Carrier Standard

2019 ◽  
Vol 16 (18) ◽  
pp. 3475
Author(s):  
Tarka ◽  
Chojecka ◽  
Paduch ◽  
Nitsch-Osuch ◽  
Kanecki ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Bactericidal Activity ◽  
Bacterial Load ◽  
Mechanical Action ◽  
Alcoholic Solution ◽  
Test Surface ◽  
Enterococcus Hirae ◽  
The Right ◽  
And Staphylococcus Aureus

Background: The effectiveness of ready-to-use disinfectant wipes was previously assessed in standardized suspension tests, which were inadequate because they ignored that the wipes are rubbed against a surface. Thus, we assessed the effectiveness of commercially available disinfectant wipes impregnated with an alcoholic solution according to the 16615 standard, which includes a test with mechanical action. Methods: According to the EN 16615 standard, under clean conditions, four squares (5cm x 5 cm), placed next to one another, were marked on a test surface. Enterococcus hirae, Pseudomonas aeruginosa, and Staphylococcus aureus were inoculated on the leftmost square, and a wipe impregnated with an alcoholic solution was placed to the left of that square. Then, the wipe was pressed with a 2.5 kg weight and moved to the right and back to the left. After contact times of 1, 5, 10, or 15 minutes, we measured the reduction in bacterial load. Results: Alcohol-based ready-to-use commercial wipes did not show sufficient bactericidal activity at the contact times of 1, 5, 10 and 15 minutes. Wipes containing propan-1-ol and a mixture of propan-1-ol and propan-2-ol were active against Pseudomonas aeruginosa at the contact times of 1 minute and 15 minutes. None of the examined wipes were active against Enterococcus hirae or Staphylococcus aureus. Conclusion: Bactericidal parameters of ready-to-use disinfectant wipes should be determined in surface tests, in addition to suspension tests, because suspension tests do not simulate the conditions under which disinfectant wipes are used in practice.

Penggunaan Limbah Logam Tembaga yang Didaur Ulang untuk Antibakteri dan Degradasi Metil Merah Secara Fotolisis

2019 ◽  
Vol 4 (1) ◽  
pp. 15
Author(s):  
Ariyetti Ariyetti ◽  
Muhammad Nasir ◽  
Safni Safni ◽  
Syukri Darajat
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Silver Nitrate ◽  
Copper Sulfate ◽  
Bacterial Growth ◽  
Methyl Red ◽  
Copper Metal ◽  
Sulfate Hydrate ◽  
Red Dye ◽  
And Staphylococcus Aureus

<p><em>Metil merah merupakan salah satu zat warna golongan azo yang sering digunakan dalam industri dan laboratorium. Penggunaan metil merah dapat menimbulkan efek terhadap kesehatan dan lingkungan. Oleh sebab itu dilakukan metode fotodegradasi dengan menggunakan semikonduktor dan radiasi sinar tampak. Semikonduktor yang digunakan yaitu berbahan dasar tembaga sulfat hidrat dan perak nitrat. Prekusor tembaga sulfat hidrat dibuat dari pengolahan limbah logam tembaga hasil pemotongan tembaga yang ada di bengkel Lembaga Ilmu Pengetahuan Indonesia (LIPI) Bandung. Bahan semikonduktor juga memiliki kemampuan dalam menghambat pertumbuhan bakteri. Hasil optimum yang didapatkan dalam proses fotodegradasi dan antibakteri merupakan gabungan antara kedua prekusor tembaga sulfat hidrat dan perak nitrat dengan bantuan penyinaran. Kemampuan dalam menghambat pertumbuhan bakteri didapatkan persentase kematian 100 % untuk masing-masing bakteri, yaitu Escherichia coli dan Staphylococcus aureus. Aktifitas fotokatalitiknya dengan konsentrasi semikonduktor 10 ppm untuk mendegradasi zat warna metil merah 5 ppm, selama 23 jam, dimana persentase degradasi yang didapatkan dengan penyinaran lebih tinggi dibandingkan dengan tanpa penyinaran. Pengaruh pH larutan terhadap degradasi metil merah yaitu optimum pada pH 12 (basa).</em></p><p><em><br /></em></p><p><em>Methyl red is one of the azo group dyes that is often used in industry and laboratories. The use of methyl red can have an effect on health and the environment. Therefore photodegradation method is done by using semiconductor and visible light radiation. The semiconductor used is based on copper sulfate hydrate and silver nitrate. The copper sulphate hydrate precursor is made from the processing of copper-cut copper metal waste in the workshop of the Indonesian Institute of Sciences (LIPI) in Bandung. Semiconductor materials also have the ability to inhibit bacterial growth. The optimum results obtained in the photodegradation and antibacterial process are a combination of both copper sulfate hydrate precursor and silver nitrate with the help of irradiation. The ability to inhibit bacterial growth obtained 100% mortality for each bacterium, namely Escherichia coli and Staphylococcus aureus. Photocatalytic activity with 10 ppm semiconductor concentration to degrade methyl red dye 5 ppm, for 23 hours, where the percentage of degradation obtained by irradiation is higher than without irradiation. The effect of pH of the solution on the degradation of methyl red is optimum at pH 12 (base).</em></p>

Cost Avoidance and Clinical Benefits Derived from a Pharmacy-Managed Anemia Program

2000 ◽  
Vol 35 (2) ◽  
pp. 169-175 ◽  
Author(s):  
Robert A. Quercia ◽  
Ronald Abrahams ◽  
C. Michael White ◽  
John D'Avella ◽  
Mary Campbell
Keyword(s):  
Cost Savings ◽  
Cost Effective ◽  
Hemodialysis Patients ◽  
Cost Avoidance ◽  
Number Of Patients ◽  
Epoetin Alpha ◽  
Clinical Benefits ◽  
Unit Dose ◽  
One Year ◽  
Alpha Therapy

A pharmacy-managed anemia program included distribution and clinical components, with the goal of making epoetin alpha therapy for hemodialysis patients more cost-effective. The Pharmacy Department prepared epoetin alpha doses for patients in unit-dose syringes, utilizing and documenting vial overfill. Pharmacists dosed epoetin alpha and iron (oral and intravenous) per protocol for new and established patients. Baseline data were obtained in 1994, one year prior to implementation of the program, and were re-evaluated in 1995 and 1998. Cost avoidance from utilization of epoetin alpha vial overfill in 1995 and 1998 was $83,560 and $91,148 respectively. In 1995 and 1998, cost avoidance from pharmacy management of anemia was $191,159 and $203,985 respectively. The total cost avoidance from 1995 through 1998 was estimated at $1,018,638. The number of patients with hematocrits under 31% decreased from 32% in 1994 to 21% and 14% in 1995 and 1998 respectively. We conclude that a pharmacy-managed anemia program for hemodialysis patients results in significant cost savings and better achievement of target hematocrits.

P1574EFFECTS OF BRAZILIAN GREEN PROPOLIS EXTRACT (EPP-AF) ON INFLAMMATION IN HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Marcelo Silveira ◽  
Flavio Teles ◽  
Erica Melo ◽  
Valeria Borges ◽  
Filipe Miranda ◽  
...  
Keyword(s):  
Control Period ◽  
Prospective Trial ◽  
Hemodialysis Patients ◽  
Intermittent Hemodialysis ◽  
Plant Materials ◽  
Propolis Extract ◽  
End Point ◽  
Number Of Patients ◽  
The Impact ◽  
Brazilian Green Propolis

Abstract Background and Aims End-stage chronic kidney disease is associated with the condition of chronic inflammation, impacting increased cardiovascular mortality in this specific population. Patients on hemodialysis are known to be predisposed to several factors that predispose to inflammation: dialysis membranes, central venous catheters, oxidative stress, fluid overload, sodium overload, uraemic toxins. Propolis, a natural resin produced by bees from plant materials, has anti-inflammatory, immunomodulatory, and anti-oxidant properties. The aim of this study was to evaluate the impact of Brazilian green propolis extract on inflammation in hemodialysis patients. Here we present preliminary results of the trial NCT04072341. Method We performed a prospective trial, open-label 9-week crossover study examining the effect of Brazilian green propolis (250mg/day, in capsules) on inflammation in hemodialysis patients. We included patients over 18 years, under intermittent hemodialysis (thrice per week), on hemodialysis for at least 1 month and until now 37 patients were included. We excluded pregnant women, cancer carried and patients who developed infection or underwent any surgical procedure during the study period. Each period was 4 weeks in duration with a 1-week washout period in between. The primary end point was change in serum level of high-sensitivity c-reactive protein (HsCRP). Secondary end point evaluated the safety of propolis use in hemodialysis patients. Results Their mean age was 58.6 ± 15.2 years (mean ± SD), and 22 (59.4%) were men. The proportion of patients with hypertension was 14 (37.8%) and diabetes was 9 (24.3%). The number of patients using arteriovenous fistula were 26 (70.2%). The HsCRP presented (mean ± SE) 5.31 ± 1.02 mg/L at baseline, 4.26 ± 0.76 mg/L after propolis period and 4.56 ± 1.32 mg/L in control period, p = 0.0042. Safety parameters were analyzed such as amylase, aspartate aminotransferase (AST) and creatine phosphokinase (CPK); there was no difference between them before and after the use of propolis. None of the participants reported any adverse effects or allergic reactions during the treatment. Conclusion Patients on hemodialysis have an increased inflammatory state. For the best of our knowledge it was the first clinical trial who demonstrated the safety of propolis in hemodialysis patients. Brazilian green propolis demonstrated a tendency to reduce inflammation in these patients.

Relative risk for cardiovascular morbidity in hemodialysis patients regarding gene polymorphism for IL-10, IL-6, and TNF

2016 ◽  
Vol 94 (10) ◽  
pp. 1106-1109 ◽  
Author(s):  
J. Tosic Dragovic ◽  
J. Popovic ◽  
P. Djuric ◽  
A. Jankovic ◽  
A. Bulatovic ◽  
...  
Keyword(s):  
Gene Polymorphism ◽  
Cerebrovascular Accident ◽  
Gene Polymorphisms ◽  
Cardiovascular Events ◽  
Medical Center ◽  
Hemodialysis Patients ◽  
Left Ventricular ◽  
Cardiovascular Morbidity ◽  
Number Of Patients ◽  
Tnf Gene

Uremia-related inflammation is prone to be a key factor to explain high cardiovascular morbidity in hemodialysis patients. Genetic susceptibility may be of importance, including IL-10, IL-6, and TNF. The aim was to analyze IL-10, IL-6, and TNF gene polymorphisms in a group of hemodialysis patients and to correlate the findings with cardiovascular morbidity. This study included 169 patients on regular hemodialysis at Zvezdara University Medical Center. Gene polymorphisms for IL-10, IL-6 and TNF were determined using PCR. These findings were correlated with the cardiovascular morbidity data from patient histories. Heterozygots for IL-10 gene showed significantly lower incidence of cardiovascular events (p = 0.05) and twice lower risk for development of myocardial infarction, but experienced twice higher risk for left ventricular hypertrophy. Regarding TNF gene polymorphism, patients with A allele had 1.5-fold higher risk for cerebrovascular accident and cardiovascular events and 2-fold higher risk for hypertension and peripheral vascular disease. Patients with G allele of IL-6 gene experienced 1.5-fold higher risks for cerebrovascular accident. We need studies with larger number of patients for definitive conclusion about the influence of gene polymorphisms on cardiovascular morbidity in hemodialysis patients and its importance in everyday clinical practice.

Mikor és hogyan integráljuk az onkológiai és a palliatív ellátást?

2021 ◽  
Vol 162 (44) ◽  
pp. 1769-1775
Author(s):  
Orsolya Horváth ◽  
Enikő Földesi ◽  
Katalin Hegedűs
Keyword(s):  
Palliative Care ◽  
Care Providers ◽  
Yale University ◽  
Early Integration ◽  
Advantages And Disadvantages ◽  
Referral Criteria ◽  
Number Of Patients ◽  
Oncology Care ◽  
The Right

Összefoglaló. A palliatív ellátások korai bevonása az onkológiai betegek ellátásába előnnyel jár mind a beteg életminősége, mind a kezelés színvonala, mind a költséghatékonyság szempontjából. Szükség van egy olyan modellre, mely alapján a megfelelő időben, a megfelelő beteg a megfelelő minőségű palliatív ellátásban részesül. Ebben a közleményben a palliatív ellátás korai integrációjának előnyei, szintjei és a speciális palliatív ellátás fogalmának ismertetése után a leginkább elterjedt beutalási modellek előnyeit és hátrányait mutatjuk be a nemzetközi szakirodalom alapján. A speciális palliatív ellátást igénylő betegek kiszűrésére szolgáló, prognózisalapú modellek hátránya, hogy nincs elég kapacitás az ilyen módon beutalt nagyszámú beteg ellátására, ezért széles körben nem terjedtek el. A tüneteken alapuló modellek sokszor bonyolultak és a mindennapi klinikai gyakorlatban nem használatosak. Az új kutatások alapján egyszerű, gyakorlatias kérdéssorokat alkalmaznak, melyekkel könnyen kiemelhetők, akik profitálnak a speciális palliatív intervencióból. Ezek közül a Yale egyetemi és a PALLIA -10 modellt ismertetjük részletesen. Amennyiben az aktív onkológiai ellátást végzők a megfelelő palliatív beutalási kritériumokat ismerik és alkalmazzák, a betegek időben jutnak a megfelelő komplex kezeléshez anélkül, hogy a palliatív ellátórendszer túlterhelődne. Orv Hetil. 2021; 162(44): 1769–1775. Summary. Early integration of palliative care into the trajectory of cancer care brings advantages into the patients’ quality of life, the level of care and cost-efficiency, too. On the basis of a predefined model, the right patient may receive the right level of palliative care at the right time. Having defined the advantages, the levels of early integration of palliative care and the concept of special palliative care, we also aim to describe the advantages and disadvantages of the most common referral models on the basis of international literature in this article. The drawback of prognosis-based models to identify patients needing special palliative care is the lack of capacity to provide care for the large number of patients so recognised; therefore they have not become widespread. Needs-based models tend to be complicated and thus rarely applied in everyday clinical practice. On the basis of new researches, simple, pragmatic questionnaires are utilised through which the patients who could benefit from special palliative care interventions are easy to identify. Here we give a detailed report of the Yale University and PALLIA-10 models. On condition that appropriate palliative referral criteria are known and applied by active oncology care providers, patients may receive adequate complex care without the palliative care system being overloaded. Orv Hetil. 2021; 162(44): 1769–1775.

Superficialization of Basilic Vein: Last Chance for a Native Arteriovenous Fistula in Hemodialysis Patients

2003 ◽  
Vol 4 (1) ◽  
pp. 21-24 ◽  
Author(s):  
M. Onaran ◽  
D. Erer ◽  
I. Şen ◽  
E.E. Elnur ◽  
E. Iriz ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Brachial Artery ◽  
Subcutaneous Tissue ◽  
Vascular Grafts ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Basilic Vein ◽  
Number Of Patients

Background Although the best type of vascular access for chronic hemodialysis patients is a native arteriovenous fistula, in an increasing number of patients all the superficial veins have been used and only the placement of vascular grafts or permanent catheters is left. Superficialization of the basilic vein is a possible alternative. Materials and Methods In 49 chronic hemodialysis patients who had no possibilities to have a native arteriovenous fistula created, we performed a basilic vein- brachial artery fistula in the arm. During the same operation the basilic vein was then superficialized for easier access for hemodialysis. Results Mean follow-up was 22.36±15.56 months. Forty-eight patients are still undergoing hemodialysis with their superficialized basilic vein native A-V fistula without any complications. Only one fistula was thrombosed just after the procedure because of poor vessel quality. Conclusion For hemodialysis patients who have no suitable superficial veins at the wrist or elbow, performing a basilic vein - brachial artery fistula and superficializing the vein to the subcutaneous tissue is an acceptable choice before deciding to use more complicated procedures like vascular grafts.

scholarly journals Transient Hydroureteronephrosis Caused by a Foley's Catheter Tip in the Right Ureter

2005 ◽  
Vol 5 ◽  
pp. 367-369 ◽  
Author(s):  
Jacob George ◽  
George Tharion
Keyword(s):  
Teaching Hospital ◽  
Tertiary Care ◽  
Abdominal Ultrasound ◽  
Physical Medicine ◽  
Urethral Catheterization ◽  
Ureteric Orifice ◽  
Unilateral Hydronephrosis ◽  
Catheter Tip ◽  
Foley’S Catheter ◽  
The Right

We report a case of unilateral hydronephrosis following urethral catheterization in a patient with T6 complete paraplegia at the Physical Medicine and Rehabilitation Department in a tertiary care teaching hospital, India. Diagnosis was established by an abdominal ultrasound. The misplaced catheter tip was withdrawn from the ureteric orifice and hydronephrosis was resolved. Foley's catheterization, a widely practiced clinical procedure, is not without its attendant risks of an inadvertent placement in the ureter leading to transient hydronephrosis. Inadequate drainage through a catheter should thus alert one to this potentially hazardous complication that can be diagnosed by an early ultrasound. This complication can be avoided by gently tugging on the catheter after inflating the catheter bulb.

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