| Records |
| 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. |
| 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 |
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| Language |
English |
Summary Language |
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Original Title |
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Abbreviated Series Title |
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Series Issue |
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Edition |
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| ISSN |
0041-1132 |
ISBN |
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Medium |
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Expedition |
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Conference |
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| Notes |
PMID:28205241 |
Approved |
no |
| Call Number |
ref @ user @ |
Serial  |
100117 |
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| Author |
Labriola, L.; Pochet, J.-M. |
| 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 |
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Place of Publication |
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| Language |
English |
Summary Language |
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Original Title |
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Series Title |
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Abbreviated Series Title |
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Series Issue |
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Edition |
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| ISSN |
1129-7298 |
ISBN |
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Medium |
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Expedition |
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Conference |
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| Notes |
PMID:28297055 |
Approved |
no |
| Call Number |
ref @ user @ |
Serial |
100066 |
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| Author |
Kane, S.P.; Hanes, S.D. |
| 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 |
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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 |
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English |
Summary Language |
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Original Title |
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Series Title |
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Abbreviated Series Title |
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Series Issue |
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Edition |
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| ISSN |
0964-3397 |
ISBN |
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Medium |
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Expedition |
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Conference |
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| Notes |
PMID:27899248 |
Approved |
no |
| Call Number |
ref @ user @ |
Serial |
100001 |
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| Author |
Hudgins, J.D.; Goldberg, V.; Fell, G.L.; Puder, M.; Eisenberg, M.A. |
| 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 |
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| 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 |
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Place of Publication |
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Editor |
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| Language |
English |
Summary Language |
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Original Title |
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Series Title |
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Abbreviated Series Title |
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Series Issue |
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Edition |
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| ISSN |
0031-4005 |
ISBN |
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Medium |
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Expedition |
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Conference |
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| Notes |
PMID:29066581 |
Approved |
no |
| Call Number |
ref @ user @ |
Serial |
99965 |
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| Author |
Gerceker, G.O.; Yardimci, F.; Aydinok, Y. |
| 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 |
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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 |
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Thesis |
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Place of Publication |
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English |
Summary Language |
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Original Title |
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Series Title |
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Abbreviated Series Title |
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Series Issue |
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Edition |
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| ISSN |
1462-3889 |
ISBN |
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Medium |
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Expedition |
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Conference |
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| Notes |
PMID:28478850 |
Approved |
no |
| Call Number |
ref @ user @ |
Serial |
99881 |
| Permanent link to this record |
