scholarly journals Use of bacteriophages in the treatment of extensively drug-resistant Pseudomonas aeruginosa septicemia in a patient with acute kidney injury – a case report

2017 ◽  
Author(s):  
SERGE JENNES
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Acute Kidney Injury ◽  
Case Report ◽  
Kidney Injury ◽  
Drug Resistant ◽  
Extensively Drug Resistant

scholarly journals Use of bacteriophages in the treatment of colistin-only-sensitive Pseudomonas aeruginosa septicaemia in a patient with acute kidney injury—a case report

Critical Care ◽  
2017 ◽  
Vol 21 (1) ◽  
Author(s):  
Serge Jennes ◽  
Maia Merabishvili ◽  
Patrick Soentjens ◽  
Kim Win Pang ◽  
Thomas Rose ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Acute Kidney Injury ◽  
Case Report ◽  
Kidney Injury

scholarly journals Ceftolozane/tazobactam versus colistin in the treatment of ventilator-associated pneumonia due to extensively drug-resistant Pseudomonas aeruginosa: a comparative cohort study

2021 ◽  
Author(s):  
Bence Mogyoródi ◽  
András Csékó ◽  
Csaba Hermann ◽  
János Gál ◽  
Zsolt Iványi
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Clinical Success ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Multivariate Regression Analysis ◽  
Ventilator Associated Pneumonia ◽  
Drug Resistant ◽  
Success Rates ◽  
Extensively Drug Resistant ◽  
All Cause Mortality

Abstract Background Resistant strains of Pseudomonas aeruginosa are common pathogens in the intensive care unit (ICU), limiting available therapeutic options. We aimed to compare ceftolozane/tazobactam (C/T) with colistimethate sodium (CMS) in the treatment of ventilator-associated pneumonia (VAP) due to extensively drug-resistant (XDR) Pseudomonas aeruginosa. Methods A retrospective, observational study was performed at a tertiary care ICU. Clinical and microbiological success rate, 28-day all-cause mortality, and adverse events were compared in patients who received C/T with those treated with systemic CMS. Results A total of 51 patients were included (18 in the C/T and 33 in the CMS group). Clinical success rates in the C/T and CMS groups were 13 (72.2 %) and 10 (30.3 %), respectively. On multivariate regression analysis, treatment with C/T was independently associated with clinical success (odds ratio 4.47, 95% CI = 1.17–17.08). There was no difference in 28-day all-cause mortality (27.8 % and 33.3 % in the C/T and CMS group, p = 0.76). Acute kidney injury was more common in patients who received CMS (48.5 % vs 11.1 %, p = 0.01). Conclusions Ceftolozane/tazobactam proved to be efficient in the treatment of XDR Pseudomonas aeruginosa VAP and showed a better safety profile compared to CMS.

scholarly journals Ceftolozane/Tazobactam Versus Colistin in the Treatment of Ventilator-Associated Pneumonia Due to Extensively Drug-Resistant Pseudomonas Aeruginosa: A Comparative Cohort Study.

2021 ◽  
Author(s):  
Bence Mogyoródi ◽  
András B Csékó ◽  
Csaba Hermann ◽  
János Gál ◽  
Zsolt D Iványi
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Clinical Success ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Multivariate Regression Analysis ◽  
Ventilator Associated Pneumonia ◽  
Drug Resistant ◽  
Success Rates ◽  
Extensively Drug Resistant ◽  
All Cause Mortality

Abstract Background: Pseudomonas aeruginosa is a common pathogen in the intensive care unit (ICU). Resistant strains are frequently isolated, leaving colistimethate sodium (CMS), the drug with known toxicity and questionable pharmacokinetics, as the last-line conventional therapeutic option.The new cephalosporin and β-lactamase inhibitor combinations like ceftolozane/tazobactam (C/T) expanded the available antibiotics for Gram-negative infections. We aimed to compare C/T with CMS in the treatment of ventilator-associated pneumonia (VAP) due to extensively drug-resistant (XDR) Pseudomonas aeruginosa. Methods: A retrospective, observational study was performed at a tertiary care ICU. Patients with VAP due to XDR Pseudomonas aeruginosa were enrolled. Clinical and microbiological success rate, 28-day all-cause mortality, and adverse events were compared in patients who received C/T with those treated with systemic CMS. Multivariate logistic regression was performed to identify predictors of clinical success. Results: A total of 51 patients were included in the study (18 in the C/T and 33 in the CMS group). The represented population was acutely and chronically severely ill with a median Acute Physiology and Chronic Health Evaluation II score of 26 (interquartile range [IQR] 20-31) and a median Charlson Comorbidity Index of 4 (IQR 3-6) without statistical significant intergroup difference. Clinical success rates in the C/T and CMS groups were 13 (72.2 %) and 10 (30.3 %), respectively. On multivariate regression analysis, treatment with ceftolozane/tazobactam was independently associated with clinical success (odds ratio 4.47, 95% CI = 1.17-17.08). There was no difference in 28-day all-cause mortality (27.8 % and 33.3 % in the C/T and CMS group, p = 0.76). Acute kidney injury was more common in patients who received CMS (48.5 % vs 11.1 %, p = 0.01). There was a tendency for lower incidence of Clostridioides difficile colitis in the C/T compared to the CMS group (0 vs 9.1%). Conclusions: Ceftolozane/tazobactam proved to be efficient in the treatment of XDR Pseudomonas aeruginosa VAP and showed a better safety profile compared to CMS. Trial registration: Retrospectively registered with ClinicalTrials.gov (identifier NCT04352855).

Successful treatment of decompression sickness complicated with acute hepatic infarction and acute kidney injury: a case report

2019 ◽  
pp. 81-85
Author(s):  
Se Hyun Oh ◽  
◽  
Hui Dong Kang ◽  
Sang Ku Jung ◽  
Sangchun Choi ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Hyperbaric Oxygen ◽  
Successful Treatment ◽  
Decompression Sickness ◽  
Kidney Injury ◽  
Pressure Change ◽  
Hepatic Infarction ◽  
Hbo2 Therapy

Decompression sickness is a disease caused by abrupt pressure change and presents various symptoms. To date, acute kidney injury associated with decompression sickness has been reported frequently, but there is no report of hepatic infarction associated with decompression sickness. We report a case of acute kidney injury and acute hepatic infarction treated with hyperbaric oxygen (HBO2) therapy and dialysis in a patient with severe decompression sickness after work diving.

scholarly journals 1597. Ceftolozane-Tazobactam and Meropenem Synergy Testing Against Multi-Drug and Extensively-Drug Resistant Pseudomonas aeruginosa

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S794-S795
Author(s):  
Mary Francine P Chua ◽  
Syeda Sara Nida ◽  
Jerry Lawhorn ◽  
Janak Koirala
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Synergistic Effect ◽  
Inhibitory Concentration ◽  
Multidrug Resistant ◽  
Additive Effect ◽  
Teaching Hospitals ◽  
Drug Resistant ◽  
Extensively Drug Resistant ◽  
Synergy Testing ◽  
Concentration Indices

Abstract Background Multidrug-resistant (MDR) and extensively drug-resistant (XDR) Pseudomonas aeruginosa (PA) have limited therapeutic options for treatment. Ceftolozane/tazobactam is a newer anti-pseudomonal drug effective against resistant PA infections, however resistance against this drug has now also developed and is increasing. In this study, we explored the combination of ceftolozane/tazobactam (CT) and meropenem (MP) as a possible effective regimen against MDR and XDR PA. Methods We obtained 33 non-duplicate isolates of MDR and XDR PA grown from blood, urine and respiratory samples collected from patients admitted between 2015 and 2019 at our two affiliate teaching hospitals. MDR PA was defined as resistance to 3 or more classes of anti-pseudomonal antibiotics, and XDR PA as resistance to all but two or less classes of anti-pseudomonal antibiotics. Antimicrobial preparations of both MP and CT were made according to manufacturer instructions. Susceptibility testing was performed using the checkerboard method in accordance to CLSI guidelines (CLSI M100, 2017). The ATCC 27853 strain of PA used as control. Synergy, additive effect, indifference and antagonism were defined as FIC (fractional inhibitory concentration) indices of ≤0.5, >0.5 to <1, >1 to <4, and >4, respectively. Results Thirteen (39%) of 33 PA isolates were classified as XDR, while 20 (61%) PA isolates were MDR. All isolates were resistant to MP (MIC50 >32 ug/mL), while only 2 (6%) isolates were susceptible to CT (MIC50 64 ug/mL). A synergistic effect was seen in 9 (27.3%) of PA isolates (FIC index range 0.28 to 0.5)— 2 of which were XDR PA, and 7 were MDR PA. An additive effect was seen in 12 (36.4%), with indifference seen in 12 (36.4%) of isolates. In this study, no antagonism was seen when CT and MP were combined. Conclusion When used in combination, CT and MP can exert a synergistic effect against MDR and XDR PA. Additive effect and indifference can also be seen when both antibiotics were used. Moreover, there was no antagonism seen when both antibiotics were combined. This study shows that the use of CT and MP in combination may be an option against XDR and MDR PA infections. Disclosures All Authors: No reported disclosures

Rhabdomyolysis, Acute Kidney Injury, and a Novel Frameshift Mutation in a Child with Glutaric Acidemia Type I

Nephron ◽  
2021 ◽  
pp. 1-6
Author(s):  
Linlin Huang ◽  
Ting Shi ◽  
Ying Li ◽  
Xiaozhong Li
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Frameshift Mutation ◽  
Novel Mutation ◽  
Kidney Injury ◽  
Febrile Illness ◽  
Type I ◽  
Continuous Venovenous Hemodiafiltration ◽  
Glutaric Acidemia Type I ◽  
Acute Decompensation

This is a case report of a girl with glutaric acidemia type I (GA-I) who experienced rhabdomyolysis and acute kidney injury (AKI). Her first acute metabolic crisis occurred at the age of 5 months, which mainly manifested as irritable crying, poor appetite, and hyperlactatemia. Mutation analysis showed 2 pathogenic mutations in the glutaryl-CoA dehydrogenase (GCDH) gene, which were c.383G>A (p.R128Q) and c.873delC (p.N291Kfs*41), the latter of which is a novel frameshift mutation of GA-I. She had a febrile illness at the age of 12 months, followed by AKI and severe rhabdomyolysis. Four days of continuous venovenous hemodiafiltration (CVVHDF) helped to overcome this acute decompensation. This case report describes a novel mutation in the GCDH gene, that is, c.873delC (p.N291Kfs*41). Also, it highlights the fact that patients with GA-I have a high risk of rhabdomyolysis and AKI, which may be induced by febrile diseases and hyperosmotic dehydration; CVVHDF can help to overcome this acute decompensation.

scholarly journals The Use of Supra-Hemodiafiltration in Traumatic Rhabdomyolysis and Acute Kidney Injury: A Case Report

2021 ◽  
pp. 26-35
Author(s):  
Gabriele Donati ◽  
Maria Cappuccilli ◽  
Federica Di Filippo ◽  
Simone Nicoletti ◽  
Marco Ruggeri ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Septic Patient ◽  
Medical Therapy ◽  
Kidney Injury ◽  
First Case ◽  
Successful Recovery

Oliguric acute kidney injury due to traumatic rhabdomyolysis can be potentially lethal if the proper medical therapy combined with extracorporeal detoxification is not performed. Different extracorporeal techniques are available to overcome this syndrome. Here, we report the first case of removal of myoglobin and successful recovery from acute kidney injury in an elderly septic patient using supra-hemodiafiltration with endogenous reinfusion technique (HFR-Supra) combined with the medical therapy.

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