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Author Loza-Correa, M.; Kou, Y.; Taha, M.; Kalab, M.; Ronholm, J.; Schlievert, P.M.; Cahill, M.P.; Skeate, R.; Cserti-Gazdewich, C.; Ramirez-Arcos, S. url  doi
openurl 
  Title Septic transfusion case caused by a platelet pool with visible clotting due to contamination with Staphylococcus aureus Type Journal Article
  Year 2017 Publication Transfusion Abbreviated Journal Transfusion  
  Volume 57 Issue 5 Pages 1299-1303  
  Keywords Aged; Anti-Bacterial Agents/therapeutic use; Central Venous Catheters/microbiology; Erythrocyte Transfusion/adverse effects; Female; Humans; Leukemia, Myeloid, Acute/therapy; Platelet Transfusion/*adverse effects; Sepsis/*etiology; Staphylococcal Infections/*transmission; *Staphylococcus aureus; Transfusion Reaction/*microbiology  
  Abstract BACKGROUND: Contamination of platelet concentrates (PCs) with Staphylococcus aureus is one of the most significant ongoing transfusion safety risks in developed countries. CASE REPORT: This report describes a transfusion reaction in an elderly patient diagnosed with acute myeloid leukemia, transfused with a 4-day-old buffy coat PC through a central venous catheter. The transfusion was interrupted when a large fibrous clot in the PC obstructed infusion pump flow. Shortly afterward, a red blood cell (RBC) unit transfusion started. After septic symptoms were developed, the RBC transfusion was also interrupted. While the RBC unit tested negative for bacterial contamination, the PC and the patient samples were found to be contaminated with a S. aureus strain that exhibited the same phenotypic and genome sequencing profiles. The isolated S. aureus forms biofilms and produces the superantigen enterotoxin-like U, which was detected in a sample of the transfused PCs. The patient received posttransfusion antibiotic treatment and had her original central line removed and replaced. DISCUSSION: As the implicated PC had been tested for bacterial contamination during routine screening yielding negative results, this is a false-negative transfusion sepsis case. Using a point-of-care test could have prevented the transfusion reaction. This report highlights the increasing incidence of S. aureus as a major PC contaminant with grave clinical implications. Importantly, S. aureus is able to interact with platelet components resulting in visible changes in PCs. CONCLUSION: Visual inspection of blood components before transfusion is an essential safety practice to interdict the transfusion of bacterially contaminated units.  
  Address Canadian Blood Services  
  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 0041-1132 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28205241 Approved no  
  Call Number ref @ user @ Serial (down) 100117  
Permanent link to this record
 

 
Author Labriola, L.; Pochet, J.-M. url  doi
openurl 
  Title Any use for alternative lock solutions in the prevention of catheter-related blood stream infections? Type Journal Article
  Year 2017 Publication The Journal of Vascular Access Abbreviated Journal J Vasc Access  
  Volume 18 Issue Suppl. 1 Pages 34-38  
  Keywords Anti-Infective Agents/adverse effects/*therapeutic use; Anticoagulants/therapeutic use; Bacteremia/diagnosis/microbiology/*prevention & control; Biofilms; Catheter-Related Infections/diagnosis/microbiology/*prevention & control; Catheterization, Central Venous/adverse effects/*instrumentation; *Catheters, Indwelling/adverse effects/microbiology; *Central Venous Catheters/adverse effects/microbiology; Equipment Design; Humans; *Renal Dialysis; Risk Factors; Treatment Outcome  
  Abstract The prevention of catheter-related blood stream infections (CRBSI) in hemodialysis (HD) patients remains a challenge because of high morbidity and mortality associated to CRBSI. Alternative locking solutions (ALS) containing an antithrombotic substance with additional antimicrobial or antibiofilm properties (citrate, ethylenediaminetetraacetic acid [EDTA], 70% ethanol, thrombolytics) with or without the addition of molecules with specific antimicrobial activity (antibiotics, taurolidine, paraben-methylene-blue) has been proposed with the aim to prevent or eradicate intraluminal biofilm colonization and subsequent CRBSI. In this review, we examine the available evidence concerning their efficacy and potential side effects, in order to determine whether ALS should be implemented widely or only in selected cases.  
  Address Department of Nephrology, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, Brussels – Belgium  
  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 1129-7298 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28297055 Approved no  
  Call Number ref @ user @ Serial (down) 100066  
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Author Kane, S.P.; Hanes, S.D. url  doi
openurl 
  Title Unexplained increases in serum vancomycin concentration in a morbidly obese patient Type Journal Article
  Year 2017 Publication Intensive & Critical Care Nursing Abbreviated Journal Intensive Crit Care Nurs  
  Volume 39 Issue Pages 55-58  
  Keywords Anti-Bacterial Agents/administration & dosage/therapeutic use; Cross Reactions/physiology; Drug-Related Side Effects and Adverse Reactions/*physiopathology; Female; Humans; Middle Aged; Obesity, Morbid/*drug therapy/physiopathology; Pneumonia, Ventilator-Associated/drug therapy/prevention & control; Vancomycin/*administration & dosage/therapeutic use; Central venous catheters; Critical care; Drug monitoring; Infectious disease; Medication safety; Vancomycin  
  Abstract INTRODUCTION: To report a case of increases in vancomycin concentrations without additional vancomycin doses being given. CASE STUDY: A 64 year-old morbidly obese female received three total doses of vancomycin for surgical prophylaxis and for ventilator-associated pneumonia. Subsequent vancomycin concentrations from the patient's central venous catheter (CVC) demonstrated increasing drug levels from 27.1 to 45.9mcg/mL despite no additional vancomycin being given and proper line flushing prior to sample collection. There is no clear explanation for the increase in the patient's vancomycin concentration. Drug leaching from the CVC, enterohepatic recycling, drug redistribution from adipose or other tissues, and assay cross-reactivity with other medications are all potential explanations for the increased vancomycin concentrations. CONCLUSION: This case report describes an unexplained increase in vancomycin concentrations and reinforces both the fallibility of laboratory testing and that unusual circumstances do occur. Several potential causes are hypothesised with CVC drug leaching being the most likely. Nurses and other healthcare providers with similar scenarios should consider a peripheral blood sample to rule out the potential for CVC drug leaching as a possible explanation.  
  Address Department of Pharmacy Practice, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States. Electronic address: scott.hanes@rosalindfranklin.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 0964-3397 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:27899248 Approved no  
  Call Number ref @ user @ Serial (down) 100001  
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Author Hudgins, J.D.; Goldberg, V.; Fell, G.L.; Puder, M.; Eisenberg, M.A. url  doi
openurl 
  Title Reducing Time to Antibiotics in Children With Intestinal Failure, Central Venous Line, and Fever Type Journal Article
  Year 2017 Publication Pediatrics Abbreviated Journal Pediatrics  
  Volume 140 Issue 5 Pages  
  Keywords Anti-Bacterial Agents/*administration & dosage; Bacteremia/diagnosis/drug therapy/epidemiology; Central Venous Catheters/microbiology; Child, Preschool; Cohort Studies; Female; Fever/diagnosis/*drug therapy/*epidemiology; Humans; Intestinal Diseases/diagnosis/drug therapy/epidemiology; Length of Stay/*trends; Male; Short Bowel Syndrome/diagnosis/*drug therapy/*epidemiology; Time-to-Treatment  
  Abstract BACKGROUND: Children with intestinal failure (IF) on parenteral nutrition (PN) are at high risk for bacteremia, and delays in antibiotic administration have been associated with increased morbidity and mortality. We designed an emergency department (ED) quality improvement (QI) initiative to reduce time to administration of intravenous antibiotics in febrile children with IF on PN. METHODS: Our aim was to decrease the mean time for febrile children with IF on PN to receive intravenous antibiotics by 50% to <60 minutes over a 12-month period. Secondary outcome measures were ED, hospital, and ICU length of stay (LOS). Our process measure was the rate of ordering recommended antibiotics, and our balancing measure was the rate of hypoglycemia. Interventions included increasing provider knowledge of IF, streamlining order entry, providing individualized feedback, and standardizing the triage process. Results were analyzed by using statistical process control methodology and time series analysis. RESULTS: We identified 149 eligible ED patients, of which 62 (41.6%) had bacteremia. The mean time to antibiotics decreased after the onset of the QI initiative from 112 to 39 minutes, and the ED LOS decreased from 286 to 247 minutes, but the total length of hospital and ICU stays were unchanged. The rate of hypoglycemia was also unchanged. CONCLUSIONS: Our QI intervention for febrile children with IF on PN shortened the time to receive antibiotics. Larger studies are needed to demonstrate the impact on overall LOS and mortality.  
  Address Division of Emergency Medicine and  
  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 0031-4005 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:29066581 Approved no  
  Call Number ref @ user @ Serial (down) 99965  
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Author Gerceker, G.O.; Yardimci, F.; Aydinok, Y. url  doi
openurl 
  Title Randomized controlled trial of care bundles with chlorhexidine dressing and advanced dressings to prevent catheter-related bloodstream infections in pediatric hematology-oncology patients Type Randomized Controlled Trial
  Year 2017 Publication European Journal of Oncology Nursing : the Official Journal of European Oncology Nursing Society Abbreviated Journal Eur J Oncol Nurs  
  Volume 28 Issue Pages 14-20  
  Keywords Adolescent; Anti-Bacterial Agents/*therapeutic use; Bacteremia/*drug therapy/*prevention & control; *Bandages; Catheter-Related Infections/*drug therapy/*prevention & control; Catheterization, Central Venous/methods; Central Venous Catheters/microbiology; Child; Child, Preschool; Chlorhexidine/*therapeutic use; Female; Humans; Infant; Infant, Newborn; Male; Patient Care Bundles; Prospective Studies; Turkey  
  Abstract PURPOSE: To compare the effects of the care bundles including chlorhexidine dressing and advanced dressings on the catheter-related bloodstream infection (CRBSI) rates in pediatric hematology-oncology patients with central venous catheters (CVCs). METHOD: Twenty-seven PHO patients were recruited to participate in a prospective, randomized study in Turkey. The researcher used care bundles with chlorhexidine dressing in the experimental group (n = 14), and care bundles with advanced dressings in the control group (n = 13). RESULTS: According to the study results, 28.6% of the patients in the experimental group had CRBSI, while this rate was 38.5% in the control group patients. The CRBSI rate in the experimental group was 3.9, and the control group had 4.4 per 1000 inpatient catheter days. There was no exit-site infection in the experimental group. However, the control group had 1.7 per 1000 inpatient catheter days. CONCLUSIONS: Even though there was no difference between the two groups in which the researcher implemented care bundles with chlorhexidine dressing and advanced dressings in terms of CRBSI development, there was reduction in the CRBSI rates thanks to the care bundle approach. It is possible to control the CRBSI rates using care bundles in pediatric hematology-oncology patients.  
  Address Ege University Hospital, Department of Paediatric Hematology-Oncology, Izmir, Turkey. Electronic address: yesim.aydinok@yahoo.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 1462-3889 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28478850 Approved no  
  Call Number ref @ user @ Serial (down) 99881  
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