Estimation of D lactat level as amarker of bacterial translocation in gut failure incritically ill pediatric patients

Background Sepsis is defined as life-threatening multi organ failure caused by a dysregulated host response to infection leading to development of gut failure, D-lactate is produced by indigenous bacteria in the gastrointestinal tract lactoferrin is important constitute of human milk and other body fluid act to improve gut function. Aim of the Work To test effect of lactoferrin supplementation for improving gut barrier function, prognosis and the outcome of septic patients using D lactate as a marker of bacterial translocation in sepsis with gut failure. Patients and Methods After ethical committee approval and informed consent from the parents, this double armed single blinded therapeutic clinical trial study was conducted on 40 Egyptian children admitted to PICUs of Ain Shams University Hospitals, by diagnosis sepsis and gut failure, twenty of them weren't supplemented with LF (group 1) and the other twenty were supplemented with it (group 2). D lactate level was measured in plasma using ELISA. Results The study show highly significant difference between Patient and control group in D lactate level, and we found no statistical difference before and after giving lactoferrin in our septic patient who weren’t in treatment of sepsis and gut failure. And we found plasma D lactate higher in non survivors with p value.048. and cut of point< 43.9 mmol\L Conclusion Lactoferrin supplementation was not beneficial in pediatric septic patient with gut failure and did not improve outcome or prognosis of patients, D lactate can be used as a predictor of intestinal failure severity and mortality. D lactate may be predictor of gut failure in sepsis and mortality

Bacteria and Sepsis: Microbiome to the Rescue?

The microbiome is the metagenome of all microbes that live on and within every individual, and evidence for its role in the pathogenesis of a variety of diseases has been increasing over the past several decades. While there are various causes of sepsis, defined as the abnormal host response to infection, the host microbiome may provide a unifying explanation for discrepancies that are seen in septic patient survival based on age, sex, and other confounding factors. As has been the case for other human diseases, evidence exists for the microbiome to control patient outcomes after sepsis. In this review, associative data for the microbiome and sepsis survival are presented with causative mechanisms that may be at play. Finally, clinical trials to manipulate the microbiome in order to improve patient outcomes after sepsis are presented as well as areas of potential future research in order to aid in the clinical treatment of these patients.

Impact of Ivabradine on renal function in septic patient with early renal impairment

Background Acute kidney injury (AKI) with sepsis increases mortality significantly. The pathophysiology of AKI during sepsis is complex and multifactorial. Lower heart rate is associated with better survival in patients with multiple organ dysfunction syndrome (MODS), a disease mostly caused by sepsis. In our study, we hypnotized that use of ivardrabine as heart rate reducing agent in septic patient with renal impairment may improve renal function. Results Fifty patients with sepsis with early renal impairment were divided in 1: 1 ratio to receive Ivabradine (group I) or not (group C). The average age of the included patients was almost 45 years, chest disorders were the main cause of sepsis in both groups. There were statistically significant differences between both groups in terms of reduction of heart rate group (I) (68.13 ± 3.34) versus (group C) (87.04 ± 3.23) and (P < 0.001) also, improvement in eGFR by Cystatin c in group (I) (103.32 ± 6.96) versus (group C) (96.25 ± 6.36) and (P < 0.001) also vasopressor dosage consumption (P < 0.001). As regards secondary outcomes, there were no statistically significant differences between study’s groups in terms of length of hospital stay (P = 0.390), need for hemodialysis (P = 0.384), and mortality (P = 1.000). Conclusions We concluded that Ivabradine as an adjuvant therapy in septic patients with renal impairment is promising agent to reduce such impairment. Trial registration Pan African Clinical Trial Registry: Identification number for the registry is PACTR201911806644230.

Complete Genome Sequence of Staphylococcus aureus Strain 834, Isolated from a Septic Patient in Japan

ABSTRACT Here, we report the complete genome sequence of Staphylococcus aureus strain 834, which was isolated from a septic patient in Japan and showed strong virulence and methicillin resistance. The complete genome consists of a 2,838,668-bp chromosome and a 24,653-bp plasmid. Genome annotation predicts 2,670 coding sequences, 16 rRNAs, and 61 tRNAs.

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

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.