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Author Zhou, Z.; Guo, D.; Zhang, F.; Wang, T.; Zhang, G.; Zhou, B.
Title Predictors of failure of catheter salvage in incident hemodialysis patients Type Observational Study
Year 2013 Publication The International Journal of Artificial Organs Abbreviated Journal Int J Artif Organs
Volume 36 Issue 5 Pages 320-326
Keywords Anti-Bacterial Agents/*therapeutic use; Catheter-Related Infections/diagnosis/microbiology/*therapy; Catheterization, Central Venous/*adverse effects/*instrumentation; Catheters, Indwelling/*adverse effects; Central Venous Catheters/*adverse effects; Chi-Square Distribution; Device Removal; Humans; Kidney Failure, Chronic/*therapy; Logistic Models; Multivariate Analysis; Odds Ratio; Prospective Studies; *Renal Dialysis; Risk Factors; Salvage Therapy; Severity of Illness Index; Time Factors; Treatment Failure; Watchful Waiting
Abstract PURPOSE: Catheter-related bloodstream infection is a frequent complication for patients who use catheter as dialysis access. This study was performed to identify the risk factors for failed catheter salvage. METHODS: We enrolled patients who received non-tunneled catheters as initial vascular access during a two-year period. Catheter salvage was attempted in all symptomatically mild patients. Patients were prospectively followed for 8 weeks starting from the day of infection. Risk factors for salvage failure were explored. RESULTS: A total of 77 bacteremia episodes occurred in 69 patient, with an infection rate of 1.61 per 1,000 catheter days. Salvage was successful in 73.4% of all episodes. We found that higher ferritin levels (greater vs. lower than 500 mg/l, (odds ratio (OR) 6.388, 95% confidence interval (CI) 2.073, 19.686), higher phosphate levels (greater vs. lower than 5.5 mg/dl, OR 4.084, 95% CI 1.391, 11.978) and shorter time intervals between catheterization and infection (within vs. beyond 3 weeks, OR 4.190, 95% CI 1.279, 13.725) predicted salvage failure. CONCLUSIONS: Catheter salvage can be a reasonable initial strategy for symptomatically mild patients. We propose salvaging aggressively and waiting watchfully; however, clinical judgment is prior to any specific management protocol.
Address Department of Nephrology, Chengdu Military General Hospital, Chengdu, China
Corporate Author Thesis
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Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0391-3988 ISBN Medium
Area Expedition Conference
Notes PMID:23645579 Approved no
Call Number ref @ user @ Serial (down) 100544
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Author Zhou, S.; Chao, X.; Fei, M.; Dai, Y.; Liu, B.
Title Analysis of S. Epidermidis icaA and icaD genes by polymerase chain reaction and slime production: a case control study Type Journal Article
Year 2013 Publication BMC Infectious Diseases Abbreviated Journal BMC Infect Dis
Volume 13 Issue Pages 242
Keywords *Biofilms; Carrier State/microbiology; Case-Control Studies; Catheter-Related Infections/microbiology; Central Venous Catheters/microbiology; Cross Infection/microbiology; DNA, Bacterial/analysis/genetics; Drug Resistance, Bacterial/genetics; Genes, Bacterial/*genetics; Humans; Microscopy, Electron, Scanning; Nasal Cavity/microbiology; Polymerase Chain Reaction; Prospective Studies; Staphylococcal Infections/*microbiology; Staphylococcus epidermidis/*genetics/isolation & purification/metabolism/*physiology
Abstract BACKGROUND: Staphylococcus epidermidis is a common pathogen in medical device-associated infections and have an ability to form adherent slime. We aimed to study the effects of icaA and icaD genes on the slime formation of Staphylococcus epidermidis associated with catheter-associated infections. METHODS: S. epidermidis isolates from the central venous catheter blood of patients with catheter-associated infections, and from the nasal vestibules of healthy volunteers, intensive care unit hospital staff, and patients, were collected. Slime phenotype was determined by Congo red agar test. The icaA/D was detected by polymerase chain reaction. Slime was examined using scanning electron microscopy. RESULTS: A total of 82 S. epidermidis isolates were collected. We found a statistically significant difference with regards to slime production between the clinical isolates from the catheter blood specimens and those from the nasal vestibules (p<0.05). All S. epidermidis slime positive strains isolated were icaA positive. There was a greater correlation between the presence of both icaA and icaD and the slime production than the single expression of icaA or icaD and the presence of slime in all groups. The co-expression of mecA and icaD was associated with enhanced resistance to antibiotics. CONCLUSION: S. epidermidis bacteria are significant nosocomial pathogens, and icaA/D can clarify the adhesion mechanism in the pathogenesis of infections associated with medical devices. This study result could be useful for the development of rapid diagnosis for slime producing and methicillin resistant S. epidermidis strains.
Address Department of Critical Care Medicine, Affiliated Provincial Hospital of Anhui Medical University, Hefei, China. az306w@gmail.com
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 1471-2334 ISBN Medium
Area Expedition Conference
Notes PMID:23705749 Approved no
Call Number ref @ user @ Serial (down) 100543
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Author Zeylemaker, M.M.; Jaspers, C.A.; van Kraaij, M.G.; Visser, M.R.; Hoepelman, I.M.
Title Long-term infectious complications and their relation to treatment duration in catheter-related Staphylococcus aureus bacteremia Type Journal Article
Year 2001 Publication European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology Abbreviated Journal Eur J Clin Microbiol Infect Dis
Volume 20 Issue 6 Pages 380-384
Keywords Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents/*therapeutic use; Bacteremia/complications/drug therapy/*etiology; Catheterization, Central Venous/adverse effects; Catheters, Indwelling/*adverse effects/microbiology; Cross Infection/blood/diagnosis/etiology; Equipment Contamination; Female; Humans; Male; Middle Aged; Retrospective Studies; Staphylococcal Infections/complications/drug therapy/*etiology; Staphylococcus aureus/isolation & purification; Time Factors; Treatment Outcome
Abstract The optimal duration of treatment for catheter-related Staphylococcus aureus bacteremia is not known. Short courses (< or = 2 weeks) of therapy should be viewed with caution because essential data on late complications, such as osteomyelitis and metastatic abscesses, are lacking. This study represents a retrospective analysis of the data from 49 adult patients hospitalised in the period 1994-1996 (mean age, 57 years; range, 20-90 years; 47% male) and from whom Staphylococcus aureus was cultured concomitantly from peripheral blood and catheter segments. Forty-six venous catheters, two arterial catheters, and one unknown type of catheter were used. Forty-four patients were treated with effective anti-Staphylococcus aureus antibiotics. Twenty patients had a favourable outcome, defined as no complication and no death during 1 year of follow-up, 24 patients had complications, 14 patients died due to attributable mortality, and 5 other patients died of an underlying disease without showing signs or symptoms of a complication. Patients were categorised according to the duration of treatment. There were small differences between a shorter (1-14 days) and a longer (>14 days) course of antibiotics with regard to favourable outcome (41% vs. 33%), complications (48% vs. 53%), attributable death (31% vs. 20%), and death due to underlying disease (41% vs. 33%), respectively. The rates of complications and death were high, but a definite conclusion cannot be drawn because the study was underpowered. More randomised trials are needed, but, until the results of such trials are available, the duration of therapy should not be shortened to less than 14 days.
Address Department of Medicine, Central Military Hospital, Utrecht, The Netherlands
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0934-9723 ISBN Medium
Area Expedition Conference
Notes PMID:11476436 Approved no
Call Number ref @ user @ Serial (down) 100542
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Author Zapotoczna, M.; Forde, E.; Hogan, S.; Humphreys, H.; O'Gara, J.P.; Fitzgerald-Hughes, D.; Devocelle, M.; O'Neill, E.
Title Eradication of Staphylococcus aureus Biofilm Infections Using Synthetic Antimicrobial Peptides Type Journal Article
Year 2017 Publication The Journal of Infectious Diseases Abbreviated Journal J Infect Dis
Volume 215 Issue 6 Pages 975-983
Keywords Animals; Anti-Bacterial Agents/*pharmacology; Biofilms/*drug effects; Catheter-Related Infections/*drug therapy; Cytokines/blood; Disease Models, Animal; Humans; Methicillin-Resistant Staphylococcus aureus/*drug effects; Microbial Sensitivity Tests; Peptides/*pharmacology; Peptides, Cyclic/pharmacology; Rats; Rats, Sprague-Dawley; Staphylococcal Infections/*drug therapy; Vancomycin/administration & dosage; *Staphylococcus aureus; *antimicrobial peptides (AMPs); *biofilm; *catheter lock solution (CLS)
Abstract Here, we demonstrate that antimicrobial peptides (AMPs) are an effective antibiofilm treatment when applied as catheter lock solutions (CLSs) against S. aureus biofilm infections. The activity of synthetic AMPs (Bac8c, HB43, P18, Omiganan, WMR, Ranalexin, and Polyphemusin) was measured against early and mature biofilms produced by methicillin-resistant S. aureus and methicillin-susceptible S. aureus isolates from patients with device-related infections grown under in vivo-relevant biofilm conditions. The cytotoxic and hemolytic activities of the AMPs against human cells and their immunomodulatory potential in human blood were also characterized. The D-Bac8c2,5Leu variant emerged as the most effective AMP during in vitro studies and was also highly effective in eradicating S. aureus biofilm infection when used in a CLS rat central venous catheter infection model. These data support the potential use of D-Bac8c2,5Leu, alone or in combination with other AMPs, in the treatment of S. aureus intravenous catheter infections.
Address Department of Microbiology, School of Natural Sciences, National University of Ireland, Galway, Ireland
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 0022-1899 ISBN Medium
Area Expedition Conference
Notes PMID:28453851 Approved no
Call Number ref @ user @ Serial (down) 100541
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Author Zaoutis, T.E.; Prasad, P.A.; Localio, A.R.; Coffin, S.E.; Bell, L.M.; Walsh, T.J.; Gross, R.
Title Risk factors and predictors for candidemia in pediatric intensive care unit patients: implications for prevention Type Journal Article
Year 2010 Publication Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America Abbreviated Journal Clin Infect Dis
Volume 51 Issue 5 Pages e38-45
Keywords Anti-Bacterial Agents/administration & dosage/adverse effects; Candidiasis/epidemiology/*etiology/*prevention & control; Case-Control Studies; Catheterization, Central Venous/adverse effects; Child; Child, Preschool; Female; Fungemia/epidemiology/*etiology/*prevention & control; Humans; Incidence; Infant; Intensive Care Units, Pediatric; Male; Neoplasms/complications; Odds Ratio; Risk Factors; Vancomycin/administration & dosage/adverse effects
Abstract BACKGROUND: Candida species are the leading cause of invasive fungal infections in hospitalized children and are the third most common isolates recovered from patients with healthcare-associated bloodstream infection in the United States. Few data exist on risk factors for candidemia in pediatric intensive care unit (PICU) patients. METHODS: We conducted a population-based case-control study of PICU patients at Children's Hospital of Philadelphia during the period from 1997 through 2004. Case patients were identified using laboratory records, and control patients were selected from PICU rosters. Control patients were matched to case patients by incidence density sampling, adjusting for time at risk. Following conditional multivariate analysis, we performed weighted multivariate analysis to determine predicted probabilities for candidemia given certain risk factor combinations. RESULTS: We identified 101 case patients with candidemia (incidence, 3.5 cases per 1000 PICU admissions). Factors independently associated with candidemia included presence of a central venous catheter (odds ratio [OR], 30.4; 95% confidence interval [CI], 7.7-119.5), malignancy (OR, 4.0; 95% CI, 1.23-13.1), use of vancomycin for >3 days in the prior 2 weeks (OR, 6.2; 95% CI, 2.4-16), and receipt of agents with activity against anaerobic organisms for >3 days in the prior 2 weeks (OR, 3.5; 95% CI, 1.5-8.4). Predicted probability of having various combinations of the aforementioned factors ranged from 10.7% to 46%. The 30-day mortality rate was 44% among case patients and 14% among control patients (OR, 4.22; 95% CI, 2.35-7.60). CONCLUSIONS: To our knowledge, this is the first study to evaluate independent risk factors and to determine a population of children in PICUs at high risk for developing candidemia. Future efforts should focus on validation of these risk factors identified in a different PICU population and development of interventions for prevention of candidemia in critically ill children.
Address Division of Infectious Diseases, Center for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA. Zaoutis@email.chop.edu
Corporate Author Thesis
Publisher Place of Publication Editor
Language English Summary Language Original Title
Series Editor Series Title Abbreviated Series Title
Series Volume Series Issue Edition
ISSN 1058-4838 ISBN Medium
Area Expedition Conference
Notes PMID:20636126 Approved no
Call Number ref @ user @ Serial (down) 100540
Permanent link to this record