Skin colonisation at the catheter exit site is strongly associated with catheter colonisation and catheter-related sepsis

2014 ◽  
Vol 103 (12) ◽  
pp. 1233-1238 ◽  
Author(s):  
Vennila Ponnusamy ◽  
Aris Perperoglou ◽  
Vidheya Venkatesh ◽  
Anna Curley ◽  
Nicholas Brown ◽  
...  
Keyword(s):  
Exit Site ◽  
Catheter Colonisation

scholarly journals 579 Central Venous Catheter Colonisation and Catheter Related Sepsis: Lessons Learnt from Exit Site Skin Swab

2012 ◽  
Vol 97 (Suppl 2) ◽  
pp. A168-A168 ◽  
Author(s):  
V. Ponnusamy ◽  
V. Venkatesh ◽  
A. Curley ◽  
A. Perperoglou ◽  
N. Brown ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Venous Catheter ◽  
Exit Site ◽  
Central Venous ◽  
Lessons Learnt ◽  
Catheter Colonisation

Diagnosis and Ablation of Fascicular Tachycardia

2011 ◽  
Vol 3 (1) ◽  
pp. 67
Author(s):  
Akihiko Nogami ◽  
Keyword(s):  
Ventricular Tachycardia ◽  
Right Bundle Branch Block ◽  
Axis Deviation ◽  
Exit Site ◽  
Rare Form ◽  
Bundle Branch Block ◽  
Diagnosis And Therapy ◽  
Narrow Qrs ◽  
Left Posterior ◽  
Qrs Morphology

Verapamil-sensitive fascicular ventricular tachycardia (VT) is the most common form of idiopathic left VT. According to the QRS morphology and the successful ablation site, left fascicular VT can be classified into three subgroups: left posterior fascicular VT, whose QRS morphology shows right bundle branch block (RBBB) configuration and superior axis (common form); left anterior fascicular VT, whose QRS morphology shows RBBB configuration and right-axis deviation (uncommon form), and upper septal fascicular VT, whose QRS morphology shows narrow QRS configuration and normal or right-axis deviation (rare form). Posterior and anterior fascicular VT can be successfully ablated at the posterior or anterior mid-septum with a diastolic Purkinje potential during VT or at the VT exit site with a fused pre-systolic Purkinje potential. Upper septal fascicular VT can also be ablated at the site with diastolic Purkinje potential at the upper septum. Recognition of the heterogeneity of this VT and its unique characteristics should facilitate appropriate diagnosis and therapy.

Exit Site Infection Due to Non Tuberculous Mycobacterium

2013 ◽  
Vol 24 (1) ◽  
pp. 44
Author(s):  
Rapur Ram ◽  
Gudithi. Swarnalatha ◽  
C. Shyamsunar Rao ◽  
G. Diwakar Naidu ◽  
Kaligotla Venkata Dakshinamurty
Keyword(s):  
Site Infection ◽  
Exit Site ◽  
Exit Site Infection

Reduction in catheter-related infections after switching from povidone-iodine to chlorhexidine for the exit-site care of tunneled central venous catheters in children on hemodialysis

2014 ◽  
Vol 18 ◽  
pp. S13-S18 ◽  
Author(s):  
Fabio Paglialonga ◽  
Silvia Consolo ◽  
Antonietta Biasuzzi ◽  
Jolanda Assomou ◽  
Elisabetta Gattarello ◽  
...  
Keyword(s):  
Povidone Iodine ◽  
Central Venous Catheters ◽  
Exit Site ◽  
Central Venous

scholarly journals Extrusion of both Superficial and Deep Cuffs of a Functional Double-Cuff Peritoneal Dialysis Catheter after Significant Weight Loss

2021 ◽  
pp. 190-194
Author(s):  
Aravindh S. Ganapathy ◽  
Myron S. Powell ◽  
James L. Pirkle
Keyword(s):  
Weight Loss ◽  
Peritoneal Dialysis ◽  
Subcutaneous Tissue ◽  
Peritoneal Dialysis Catheter ◽  
Dialysis Catheter ◽  
Review Of The Literature ◽  
Significant Weight Loss ◽  
Exit Site ◽  
Special Circumstances ◽  
Uncommon Complication

Extrusion of the superficial cuff of a peritoneal dialysis (PD) catheter is an uncommon complication that may be associated with infection or malfunction. However, extrusion of both the superficial and deep cuffs of a double-cuff catheter is rare and uniformly associated with failure and peritonitis. We report a case of a presternal-type PD double-cuff catheter with extrusion of both cuffs through an abdominal exit site after 6 years of use that has remained functional, which has not been previously reported. In this case, the patient had achieved a 60-kg weight loss resulting in retraction of the subcutaneous tissue around both cuffs, while the catheter was held in place by the titanium connector between the presternal extension tubing and the inner, coiled catheter. In such special circumstances, extrusion of both cuffs may not necessitate urgent catheter removal. A review of the literature revealed previous cases of superficial cuff extrusions with catheters remaining functional but not with deep cuff extrusion.

scholarly journals Outbreak of Burkholderia cepacia Complex Due to Multiple Brands of Contaminated Aqueous Chlorhexidine in Hong Kong

2020 ◽  
Vol 41 (S1) ◽  
pp. s337-s337
Author(s):  
Shuk-Ching WONG ◽  
Vincent Chi-Chung CHENG
Keyword(s):  
Hong Kong ◽  
Peritoneal Dialysis ◽  
Burkholderia Cepacia ◽  
Environmental Samples ◽  
Community Pharmacies ◽  
Site Visit ◽  
Newly Diagnosed ◽  
Environmental Isolates ◽  
Exit Site ◽  
Culture Positive

Background: Contaminated chlorhexidine produced by a single company has been implicated in the outbreak or pseudo-outbreak of Burkholderia cepacia complex (BCC). However, simultaneous occurrence of multiple brands of contaminated chlorhexidine supplied by different manufacturers resulting in a persistent outbreak for >1 year has not been well described. Objective: We report an outbreak of BCC with epidemiological investigation and using whole-genome sequencing (WGS) analysis of patient and environmental isolates in Hong Kong. Methods: Upon the investigation of a cohort of renal patients undergoing peritoneal dialysis colonized or infected with BCC in their exit sites, different brands of 0.05% aqueous chlorhexidine (aqCHX) used for exit site dressing, supplied from hospital or purchased from community pharmacies by patients, were cultured. A risk factor analysis for exit-site acquisition of BCC was performed. A site visit to a local manufacturer was conducted to investigate the process of production and to collect environmental samples for culture, which were further analyzed by WGS along with the BCC isolates cultured from patients and aqCHX purchased from community pharmacies. Results: Four patients undergoing peritoneal dialysis had cultures positive for BCC in the exit site swab in September 2019. A snapshot screening revealed 88 (32.0%) of 275 renal dialysis patients colonized with BCC. Of these patients, 47 (17.1%) were newly diagnosed and 41 (14.9%) were known to be colonized or infected with BCC according to retrospective data retrieval from January 1, 2018. A significantly greater proportion of patients with newly diagnosed BCC (cases) had used contaminated aqCHX for exit-site dressing than those with culture negative for BCC (controls): 38 of 47 (80.9%) versus 54 of 187 (28.9%) (P < .001). Of 161 aqCHX samples, 10 brands from 4 manufacturers (purchased from community pharmacies), 125 (77.6%) were culture positive for BCC, whereas all 77 aqCHX samples supplied by the hospital, which are different brands and are produced by different manufacturers, were proven to be sterile. Of the 28 environmental samples taken from a local manufacturer during the site visit, 19 samples (67.9%, 3 collected from the instrument for production of aqCHX and all 16 newly produced aqCHX samples) were culture positive for BCC. WGS revealed 3 major clusters characterized by B. cenocepacia genomovar IIIA ST1547 and 2 novel MLST clusters from 52 patients and 26 environmental isolates selected. Conclusions: This outbreak was terminated by product recall, and the government has decided to take regulatory actions to ensure the sterility of antiseptics, including aqCHX.Funding: NoneDisclosures: None

scholarly journals Repeat exit site infection in peritoneal dialysis patient with polycythemia vera – a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Edyta Gołembiewska ◽  
Kazimierz Ciechanowski
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Peritoneal Dialysis ◽  
Case Report ◽  
Polycythemia Vera ◽  
Significant Risk ◽  
Renal Amyloidosis ◽  
Site Infection ◽  
Exit Site ◽  
Exit Site Infection ◽  
First Case

Abstract Background Infectious complications of peritoneal dialysis (PD) remain a common cause of catheter loss and discontinuation of PD. Exit site infection (ESI) constitutes a significant risk factor for PD-related peritonitis and determination of predisposing states is relevant. We here present a case of repeat ESI due to Pseudomonas aeruginosa in a PD patient with skin changes in the course of polycythemia vera (PV). Case presentation A 73-year-old PD patient with chronic kidney disease secondary to renal amyloidosis and ankylosing spondylitis, presented to the nephrology unit with signs of ESI. In 2006 he was diagnosed with PV and since then has was successfully treated with hydroxyurea; however, he reported recurrent episodes of developing skin nodules in the course of the disease. Exit site swab yielded Pseudomonas aeruginosa and the infection developed in the ulcerated PV nodule that appeared in exit site 2 weeks earlier. Patient was treated with intraperitoneal amikacin and oral ciprofloxacin, however, due to neurological complications, the treatment had to be interrupted and finally catheter was removed. Similar episode of ESI with Pseudomonas aeruginosa developed in the patient two years earlier and also required catheter removal. Conclusion This is the first case report demonstrating the development of ESI on the polycythemia vera skin lesion in this area. Skin manifestations of PV might be a predisposing factor to ESI in PD patients.

Exit-Site Infection during Continuous and Cycling Peritoneal Dialysis in Children

1990 ◽  
Vol 10 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Maurice Levy ◽  
J. Williamson Balfe ◽  
Dennis Geary ◽  
Sue Fryer-Keene ◽  
Robert Bannatyne
Keyword(s):  
Peritoneal Dialysis ◽  
Site Infection ◽  
Exit Site ◽  
Exit Site Infection ◽  
Daily Dialysis ◽  
Pseudomonas Species ◽  
Before And After ◽  
Species Being ◽  
Catheter Replacement

A 10-year retrospective review of pediatric patients on peritoneal dialysis showed that 50 of 83 had 132 episodes of exit-site infection (ESI). Thirty-nine episodes were purulent. The most prevalent organism was Staphylococcus aureus. Staphylococcus epidermidis was also common, usually occurring in purulent infections. Gramnegative organisms were responsible for 23 ESls, with Pseudomonas species being the most common. Age, sex, concomitant primary disease type, length of training, dressing techniques, quality of daily dialysis technique, use of diapers, and pyelostomies did not affect the incidence of ESI. However, 40% of children with a skin infection from other sites had associated peritoneal catheter ESI. Thirty-eight episodes of ESI in 28 patients resulted in peritonitis; the main organisms involved were Staphylococcus and Pseudomonas species. Catheters were replaced in 13 patients with peritonitis, but there was no difference in the incidence of ESI before and after catheter replacement.

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