Temocillin dosage adjustment in a preterm infant with severe renal disease: a case report

2020 ◽  
Vol 75 (12) ◽  
pp. 3652-3655
Author(s):  
Guillaume Dumangin ◽  
Matthieu Brenkman ◽  
Elise Pape ◽  
Allan Kolodziej ◽  
Nicolas Gambier ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Renal Disease ◽  
Preterm Infant ◽  
Paediatric Population ◽  
Urinary Concentration ◽  
Severe Renal Disease ◽  
Stage Renal Disease ◽  
Tract Infections ◽  
End Stage

Abstract Background Temocillin is a carboxypenicillin antibiotic indicated in complicated urinary tract infections due to susceptible ESBL-producing Enterobacteriaceae. While temocillin therapeutic schemes for adult patients with normal or impaired renal function are evidence based, little is known in paediatric populations. Objectives We report herein the management of temocillin treatment in a preterm infant with end-stage renal disease. Patients and methods The patient was a 7-month-old preterm infant born at 35 weeks gestation and treated by temocillin for 10 days for a bacteraemic urinary tract infection due to a susceptible ESBL-producing Enterobacter cloacae complex strain. Temocillin was administered by continuous infusion using a loading dose of 25 mg followed by a maintenance dose of 70 mg daily. Determination of MIC and temocillin plasma and urinary concentration was performed. Results Clinical improvement was observed 24 h after the initiation of temocillin treatment. Temocillin concentrations ranged between 21.6 and 35.5 mg/L in urine between the first and the sixth day of treatment and between 47.0 and 61.8 mg/L in plasma after 6 and 10 days of treatment, respectively. Temocillin concentrations were found to be above the determined MIC of 6 mg/L. From the measured concentrations, we can postulate that 100%fT>MIC was achieved in urine and at least equal to 40% in plasma. Conclusions Temocillin dosing adjustment performed in the present reported case allowed safe and effective treatment. The strategy described herein could be used as a basis for further clinical studies relative to temocillin use in a paediatric population with renal impairment.

scholarly journals Urine Bacteriology in Post-Kidney Transplant Patients with Double-J Stents

2021 ◽  
Vol 7 (4) ◽  
pp. 358-364
Author(s):  
S Abu ◽  
MC Igbokwe ◽  
OO Olatise ◽  
M Okafor ◽  
SO Asaolu ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Urinary Tract ◽  
Renal Disease ◽  
Kidney Transplant ◽  
End Stage Renal Disease ◽  
Bacterial Colonisation ◽  
Transplant Patients ◽  
Stage Renal Disease ◽  
Tract Infections ◽  
End Stage

Background: Kidney transplantation is the gold standard treatment modality for patients with end-stage renal disease. Ureteric stenting is commonly used during kidney transplantation to reduce the incidence of ureteric complications post-transplantation. The presence of ureteric stents could be complicated by bacterial colonisation and urinary tract infections. Objective: To identify the urinary flora in patients with double-J stents following kidney transplantation and establish bacteria colonisation and their antimicrobial susceptibility. Methods: Over one-year, single urine samples of consecutive 100 post-renal transplant patients were subjected to bacteriologic analysis. Early morning midstream urine was obtained into a sterile bottle from all the participants for laboratory analysis. Results: The mean age of post kidney transplantation patients was 47.6 ±12.3 years. Hypertension and diabetes were the commonest co-morbidities associated with End-Stage-Renal-Disease (ESRD), accounting for 61% and 28%, respectively. E. coli was the commonest isolate (70.4%). Microbiological evidence of Urinary Tract Infection (UTI) revealed by pyuria (pus cells >4/HPF) was found in 40.9%. Tigecycline, nitrofurantoin and tetracycline showed the highest sensitivity pattern in 9%, 8% and 8%, respectively, with significant resistance against cephalosporins and fluoroquinolones. Conclusion: The fourth week of double-J ureteric stent insertion in kidney transplant recipients showed a high incidence of urinary bacterial colonisation.

End-stage renal disease in the course of urinary tract defects in Wolf–Hirschhorn syndrome – case report

2014 ◽  
Vol 1 (2) ◽  
pp. 229-236
Author(s):  
Katarzyna Jungiewicz ◽  
◽  
Irena Makulska ◽  
Anna Medyńska ◽  
Danuta Zwolińska ◽  
...  
Keyword(s):  
Case Report ◽  
Urinary Tract ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Increased Risk of End-Stage Renal Disease in Familial IgA Nephropathy

2002 ◽  
Vol 13 (2) ◽  
pp. 453-460
Author(s):  
Francesco Paolo Schena ◽  
Giuseppina Cerullo ◽  
Michele Rossini ◽  
Salvatore Giovanni Lanzilotta ◽  
Christian D’Altri ◽  
...  
Keyword(s):  
Renal Disease ◽  
Iga Nephropathy ◽  
End Stage Renal Disease ◽  
Upper Respiratory Tract ◽  
Renal Survival ◽  
First Degree Relatives ◽  
Increased Risk ◽  
Stage Renal Disease ◽  
Tract Infections ◽  
End Stage

ABSTRACT. Primary IgA nephropathy (IgAN) is characterized by recurrent episodes of macroscopic hematuria accompanied by upper respiratory tract infections or persistent asymptomatic microscopic hematuria with or without proteinuria. IgAN may involve one or more members of a family. Three generations of a cohort of 110 patients with biopsy-proven IgAN, living in Southern Italy, were checked for urinalysis, and the relative risk (RR) of developing the disease was evaluated. A total of 19 unrelated familial, 37 suspected, and 54 sporadic cases of IgAN were identified. Renal survival was estimated by the Kaplan-Meier method for censored data and compared by use of the log-rank test. More than 50% of the patients with IgAN clustered in kindred with more than two probably affected relatives. In 19 unrelated IgAN families, 8 had single-generation (SG) and 11 multigenerational (MG) involvement showing a prevalent vertical transmission of the trait. The RR was 16 times higher in first-degree relatives (odds ratio [OR], 16.4; 95% confidence interval [CI], 5.7 to 47.8; P < 0.0001) and >2 times higher, even if NS, in second-degree relatives (OR, 2.4; 95 % CI, 0.7 to 7.9; P = 0.145). The clinical and histologic picture of familial and sporadic IgAN appeared to be similar. The 20-yr renal survival rate from the apparent onset of the disease was significantly poorer in patients with familial (41%) than in patients with sporadic (94%) IgAN (P = 0.003). Furthermore, 15-yr renal survival from the time of renal biopsy was significantly worse in familial IgAN (P = 0.02); end-stage renal disease was present in 64% of familial and only in 8% of patients with sporadic IgAN. Finally, renal survival was significantly worse in patients belonging to families with SG rather than with MG involvement (P = 0.03). These data show, for the first time, that familial IgAN may be considered a nonbenign disease that occurs frequently in first-degree relatives. Familial IgAN has a poorer outcome than sporadic IgAN. Therefore, an accurate family history and urinalysis in all family members is urgently recommended in clinical practice. This procedure might avoid late referral of subjects with persistent and underestimated urinary abnormalities and late diagnosis of the disease.

Clinical Study of Urinary Tract Tumors in Patients with Maintenance Dialysis for End Stage Renal Disease

2019 ◽  
Vol 3 (1) ◽  
pp. 9-12
Author(s):  
Chang-Li Xu ◽  
Hui Xu ◽  
Jin-Qi Song ◽  
Ya-Nan Zhou
Keyword(s):  
Urinary Tract ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Causes Of Death ◽  
Dialysis Patients ◽  
Gross Hematuria ◽  
Maintenance Dialysis ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Impact

Introduction: The research in the past ten years shows that the incidence of malignant tumors in dialysis patients is significantly higher than that in normal people. The highest proportion of urinary tumors is one of the main causes of death in patients with end-stage renal disease, and the incidence is gradually increasing. However, the high-risk factors of urinary tract tumors in dialysis patients have not yet been fully elucidated, so exploring this issue is an important issue that the medical community needs to solve. The objectives of this study are to understand the clinical characteristics of maintenance dialysis patients with urinary tract tumors and the influence of related factors on their prognosis. Methods: The clinical data of 22 patients with urinary tract tumors in maintenance dialysis (MHD) from the Affiliated Hospital of Chengde Medical College from January 2013 to June 2018 were retrospectively analyzed. The incidence of urinary tumors and clinical diagnosis and treatment were investigated. And prognosis, analysis of the impact of various relevant factors on the overall survival of patients with dialysis and urinary tumors. Results: The 912 patients with maintenance dialysis, 22 patients had urinary tumors with an incidence of 2.41%. Among them, 13 patients were bladder tumors, 7 patients were renal or ureteral tumors, 1 patient was renal tumor, and 1 patient was prostate cancer. There were 17 cases of intermittent and painless gross hematuria, 2 cases of gross hematuria, 1 case of lumbar pain, 1 case of abdominal pain and dysuria, 1 case of frequent urination and dysuria. Ten patients underwent surgery, and 4 patients died. The postoperative survival of the patients was 12~103 months, with an average of 58.75 months. 12 patients were unable to undergo surgery because of other diseases or economic reasons; in 9 the disease was found during autopsy. The time from tumor to death was 14~38 months, with an average of 24.11 months. The causes of death in 13 death patients: 5 patients were myocardial infarction, 3 patients were heart failure, 3 patients were tumor metastasis, and severe sepsis in 2 patients. Conclusion: There is increased propensity of GU tumors in maintenance dialysis patients. The tumors are of higher grade and demonstrate poor prognosis. Therefore, attention should be paid to the monitoring of urinary tract tumors in maintenance dialysis patients, especially elderly patients without cardiovascular and cerebrovascular complications, because their life expectancy can be longer.

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