scholarly journals Frequency and Microbiological Profile of Catheter-Related Infections in Hemodialysis Patients Receiving Gentamicin as Antimicrobial Lock Therapy for Prophylaxis

2021 ◽  
Vol 4 (03) ◽  
Author(s):  
Sumbal Nasir Mahmood ◽  
Sabaa Asif ◽  
Muhammad Amim Anwar ◽  
Osama Kunwer Naveed
Keyword(s):  
Blood Culture ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Cross Sectional Study ◽  
Immunosuppressive Drugs ◽  
Hemodialysis Patients ◽  
Exit Site ◽  
Cross Sectional ◽  
Exit Site Infection ◽  
Antibiotic Lock

Antibiotic lock solution (ALS) in the lumen of catheter is a mean to decrease the possibility of catheter related blood stream infection (CRBSI). We conducted this study using Gentamicin as ALS to observe the frequency of catheter related infections (CRI) including CRBSI and exit site infection in this hemodialysis patients being dialyzed through tunneled and temporary hemodialysis catheters. Methods This descriptive, cross sectional study was conducted at Dr. Ziauddin Hospital, North Campus between January 2017- December 2017. Symptomatic patients for CRBSI were included in this study. Blood culture from the catheter ports and periphery and exit site swab if pus visible were sent for culture sensitivity.  Results Total 138 patients of either gender with age more than 18 years to less than 80 years were evaluated. 44.9% were male and mean age of patients was 58.79±14.05 years. 70.3% patients were diabetic for 15.61±4.61 years and 11.6% were using immunosuppressive drugs. The overall mean catheter duration was 22.27±14.39 days and mean hemodialysis duration was 25.32±44.31 weeks. Tunneled catheter was placed in 40.6% and 46.4% had femoral temporary catheters. Blood culture was done for 51 cases and 21.5% were positive. Tip culture was positive in 33.3% patients. In our study, 23.18% patients were found to have catheter related infections, out of which 61.5% were found with gentamicin resistance including colonization. Conclusion We report a high frequency of catheter related infections despite using ALS as prophylaxis, with predominant organisms being gram positives and a high incidence of gentamycin resistance.

scholarly journals The Impact of the Introduction of Innovative REDS Scale for the Evaluation of Central Tunnelled Catheter (CTC) Exit Site on Infection Prevention in Long-Term Haemodialyzed Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Tomasz Porazko ◽  
Edyta Stasiak ◽  
Marian Klinger
Keyword(s):  
Blood Stream Infection ◽  
Bloodstream Infections ◽  
Cost Effective ◽  
Blood Stream ◽  
Site Infection ◽  
Exit Site ◽  
Exit Site Infection ◽  
The Impact

Central tunneled catheter (CTC)-related infections are a leading cause of a catheter loss, thus being the source of significant morbidity and mortality. The study aims at evaluating the impact of the implementation of the innovative redness, edema, discharge and tenderness, symptoms (REDS) scale (devised by the authors) for the description of the tunnel condition on the frequency of infection in long-term catheter users. The same cohort of the 40 patients was observed for 4 years altogether: 2 years before and 2 years after REDS application. The results, as well as follow-up evaluation of participants, were compared. The 2-year cumulative incidence of the CTC exit site infection (ESI) dropped significantly (log-rank p < 0.001) from 0.89 episode/1,000 catheter days (53.5%, 95% CI [35.9%; 66.2%]) in the period before REDS was used—to 0.26 episode/1,000 catheter days (18.6%, 95% CI [6.1%; 29.4%]) in the time of REDS application. There were also significantly fewer episodes of ESI complicated with catheter-related blood stream infection (CRBSI) requiring the CTC removal (0.6 episode/1,000 catheter days; 18.6%, 95% CI [6.1%; 29.4%] vs. 0.3 episode/1,000 catheter days; 4.7%, 95% CI [0.0; 10.7%]; log-rank p = 0.04, in pre-REDS and REDS time, respectively). The REDS scale appears to be a simple, cost-effective tool reducing the frequency of the tunneled CTC exit site infection and associated bloodstream infections.

Device associated healthcare associated infections in a pediatric intensive care unit of a Tertiary Care Hospital, Pakistan.

2021 ◽  
Vol 28 (03) ◽  
pp. 338-343
Author(s):  
Shah Ali Ahmed ◽  
Anwarul Haque ◽  
Qalab Abbas ◽  
Humaira Jurair ◽  
Zohra Qamar ud Din ◽  
...  
Keyword(s):  
Intensive Care ◽  
Blood Stream Infection ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Blood Stream ◽  
Central Line ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Care Hospital ◽  
Cross Sectional

Objective: To determine the frequency of Ventilator associated Pneumonia (VAP), Central Line Associated Blood Stream Infection (CLABSI) and Catheter Associated Urinary Tract infection (CAUTI) by using standardized criteria established by Center of disease control and prevention. Study Design: Cross-sectional study. Setting: PICU of Aga Khan University Hospital (AKUH). Period: (August 2015 to January 2016). Material & Methods: Data was collected on a pre-coded proforma. Data was entered and analyzed through SPSS. Results: 156 patients were enrolled. 102 (65.4%) were male. Mean age was 57.59 months. Mean length of stay was 5.6 days. Patient and Device days were 546 and 958 respectively. Device utilization ratio was 0.56. Four Device associated infections (DAI) were identified during study period with a DAI Rate of 4.17 per 1000 device days. All DAI were CLABSIs. Enterococcus was the most frequent bacterial isolate. Conclusion: DAI are highly prevalent in low resource countries, especially in intensive care areas including PICUs. In our setup, CLABSI are increasing while VAP and CAUTI are decreasing.

scholarly journals Peritonitis and catheter exit-site infection in patients on peritoneal dialysis at home

2015 ◽  
Vol 23 (5) ◽  
pp. 902-909 ◽  
Author(s):  
Ana Cristina Freire Abud ◽  
Luciana Kusumota ◽  
Manoel Antônio dos Santos ◽  
Flávia Fernanda Luchetti Rodrigues ◽  
Marta Maria Coelho Damasceno ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Descriptive Analysis ◽  
Cross Sectional Study ◽  
Site Infection ◽  
Exit Site ◽  
Peritoneal Catheter ◽  
Cross Sectional ◽  
Exit Site Infection ◽  
Length Of Treatment ◽  
At Home

Objective: to analyze the complications related to peritonitis and catheter exit-site infections, in patients on peritoneal dialysis at home.Method: quantitative and cross-sectional study, carried out with 90 patients on peritoneal dialysis at home, in a municipality in the Northeast region of Brazil. For data collection, it was used two structured scripts and consultation on medical records. Descriptive analysis and comparison tests among independent groups were used, considering p<0.05 as level of statistical significance.Results: by comparing the frequency of peritonitis and the length of treatment, it was found that patients over two years of peritoneal dialysis were more likely to develop peritonitis (X²=6.39; p=0.01). The number of episodes of peritoneal catheter exit-site infection showed association with the length of treatment (U=224,000; p=0.015).Conclusion: peritonitis and catheter exit-site infection are associated with the length of treatment.

scholarly journals Hemodialysis catheter related blood stream infections

2018 ◽  
Vol 6 (2) ◽  
pp. 562
Author(s):  
Tanuja Nambakam Subramanyam ◽  
Girish P. Vakrani
Keyword(s):  
Blood Sample ◽  
Early Result ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Hemodialysis Patients ◽  
Morbidity And Mortality ◽  
Catheter Removal ◽  
Exit Site ◽  
Hemodialysis Catheter ◽  
Catheter Tip

Background: Hemodialysis catheter related blood stream infection (CRBSI) is common cause for sepsis in hemodialysis patients with high morbidity and mortality. It has to be diagnosed promptly for early treatment to avoid serious complications including catheter removal. This prospective study was undertaken to study clinical features, to validate use of cultures drawn from different sites for diagnosis and management of hemodialysis catheter related blood stream infection (CRBSI). As there is paucity of data regarding CRBSI, hence the study was undertaken.Methods: All hemodialysis patients with CRBSI between October 2016 to October 2017 were included. Variables like different catheter position, blood cultures collected from peripheral vein, both catheter hubs, catheter exit site swab, and catheter tip cultures were analyzed with respect to time to culture positivity, microbes and its management were analyzed.Results: Mean duration of hemodialysis catheter inside patient was 24days, most common risk factor for CRBSI was diabetes mellitus (58%) followed by surgery (50%), previous dialysis catheterization within preceding 2months (33%). 30% patients had history of guide wire exchange of catheters previously, most had temporary catheter (88%), most common site of catheter was right internal jugular vein (58%). Cultures showed gram positive organisms in 63%. It was found that same monomicrobial growth was noted in most cultures stating less chances of contamination. Exit site, catheter tip samples and blood sample from catheter’s venous hub yielded early result. It was found that same monomicrobial growth was noted in most cultures stating less chances of contamination. Among complications, 8% had endocarditis, 61% had catheter removal. Average hospital stay was 9days. Deferve scence was noted upon antibiotic therapy and catheter removal in most cases. Death was noted in 8% due to sepsis.Conclusions: CRBSI are major cause of admissions, morbidity and mortality in hemodialysis patients on catheters. Gram positive organisms were commonest pathogens causing CRBSI. Exit site, catheter tip samples and blood sample from catheter’s venous hub yielded early result. Peripheral blood sampling for culture diagnosing was unnecessary. Most requires 2-6weeks systemic antibiotics and catheter removal especially if persistent fever and systemic complications are present.

scholarly journals Bacterial and Fungal Profile, Drug Resistance Pattern and Associated Factors of Isolates Recovered From Blood Samples of Patients Referred to Ethiopian Public Health Institute: Cross-Sectional Study

2021 ◽  
Author(s):  
Etsehiwot Adamu Tsegaye ◽  
Dejenie Shiferaw Teklu ◽  
Zelalem Tazu Bonger ◽  
Abebe Assefa Negeri ◽  
Tesfaye Legesse Bedada ◽  
...  
Keyword(s):  
Risk Factors ◽  
Burkholderia Cepacia ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Blood Stream Infections ◽  
Gram Positive Bacteria ◽  
Blood Specimens

Abstract Background Blood stream infections are serious infections that usually induce prolongation of hospital stay, morbidity and mortality in several countries including Ethiopia. The aim of this study was to determine bacterial and fungal profile, their drug resistance patterns, and risk factors associated with blood stream infections. Methods A cross sectional study design was conducted from February 23 to June 23, 2020 at Ethiopian public health. A structured questionnaire was used to collect data on socio-demographic factors and clinical conditions. Blood specimens were analyzed using standard microbiological techniques. Antimicrobial susceptibility tests were performed using Kirby-Bauer disc diffusion technique and Vitek compact 2. Simple and multiple logistic regressions were used to assess the potential risk factors. Results A total of 175 pathogens isolated from 346 blood specimens. Of these, 60% Gram-negative bacteria, 30.86% Gram-positive bacteria and 9.14% fungal isolates were identified. Burkholderia cepacia and Coagulase negative staphylococcus were the predominant pathogen among Gram-negative and Gram-positive bacteria respectively. Among fungus, Candidia krusei (56.25%) was the most predominant isolate. The highest proportions of antibacterial resistance were observed among 3rd generation cephalosporin and penicillin. Most fungal isolates expressed resistance to fluconazole. Sex (p = 0.007), age (p < 0.001) and use of invasive medical devices (p = 0.003) were identified as risk factors for bacterial blood stream infections. Conclusion The study showed high prevalence of blood stream infection was due to Burkholderia cepacia and non-Candidia albicans spp. This finding alarming ongoing investigation of blood stream infection is important for recognizing future potential preventive strategies including environmental hygiene and management of comorbid medical diseases to reduce the problem.

scholarly journals PATHOGENS CAUSING BLOOD STREAM INFECTIONS

2015 ◽  
Vol 22 (12) ◽  
pp. 1617-1623
Author(s):  
Muhammad Saeed ◽  
Farhan Rasheed ◽  
Fouzia Ashraf ◽  
Shagufta Iram ◽  
Shahida Hussain ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Cardiac Surgery ◽  
Blood Culture ◽  
Blood Stream ◽  
Cross Sectional Study ◽  
Blood Cultures ◽  
Gram Positive ◽  
Cross Sectional ◽  
Blood Stream Infections ◽  
Gram Negative

Blood stream infections (BSI) remain a major cause of debility and death aroundthe world. BSI accounts for 10-20% of all Nosocomial infections. Empirical antimicrobials arebased on the susceptibility pattern of the pathogens isolated in a specific institute from timeto time. We have conducted this study only on cardiac Patients over two & half years of studyduration. Study design: Cross sectional study. Settings: Microbiology Department, Allama IqbalMedical College/Jinnah Hospital, Lahore. Study Period: January 2013 to July 2015. Materials& Methods: A total of 5411 blood culture specimens were collected from cardiac patientsincluding patients admitted to cardiology ward, coronary care unit (CCU), pre-operative andpost-operative cardiac surgery patients. The bottles containing BHI broth were incubated andwere subcultured after 24 hours, 72 hours, 120 hours, and 168 hours on blood and MacConkeyagars. Isolates were further identified with the help of Gram staining, biochemical reactionsand rapid tests like catalase, oxidase, coagulase, Analytical Profile Index (API) 20E and API20NE. Antimicrobial susceptibility of the isolate was carried out on Mueller-Hinton agar byModified Kirby Bauer disc diffusion technique according to the isolate as per recommendationsof Clinical and Laboratory Standards Institute (CLSI) guidelines 2013. Results: Out of total 5411patients, 3958(73.14%) were male, 1453(26.85%) were females. Out of total 5411 Specimens,only 486 (8.98%) were positive for bacterial growth. Out of total 486 positive blood cultures,261 (53.71%) were Gram positive isolates and 225 (46.29%) were Gram negative isolates.Out 486 positive blood cultures, 96 (19.75%) were from cardiology ward, 67 (13.78%) werefrom CCU, 113 (23.25%) were from pre operative cardiac surgery ward, 210 (43.20%) werefrom post operative cardiac surgery ward. Among Gram positives, Staphylococcus Specieswere most common organism isolated from 246 (50.61%) blood culture specimens. AmongGram negatives, Pseudomonas aeruginosa and E.coli were predominant organisms, isolatedfrom 81(16.66%) and 72(14.81%) blood culture specimens respectively. Conclusion: GramPositive isolates were more common as compared to Gram negative isolates. Vancomycin andLinezolid were the most effective drugs among Gram positive isolates. Piperacillin-Tazobactamwas most potent antimicrobial against Pseudomonas aeruginosa. For coli forms Tigecyclinewas most effective drug.

Procalcitonin Level as a Surrogate for Catheter-Related Blood Stream Infection among Hemodialysis Patients

2017 ◽  
Vol 18 (6) ◽  
pp. 498-502 ◽  
Author(s):  
Mahmoud Hamada Imam ◽  
Eman Gamal
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Blood Stream Infection ◽  
Positive Culture ◽  
Blood Stream ◽  
Hemodialysis Patients ◽  
Reactive Protein ◽  
Markers Of Inflammation ◽  
Spearman Correlation Test ◽  
Time Of Presentation

Introduction Catheter-related bloodstream infection (CRBSI) is a frequent complication among hemodialysis patients who usually are presented with nonspecific signs such as fever, rigors, and hypotension. Blood culture will take up to 5 days and antimicrobials will be started. Procalcitonin (PCT) is a valid marker in sepsis. Our goal in this study is to evaluate its usefulness as a diagnostic marker in detecting CRBSI among hemodialysis patients who present with suspected CRBSI. Patients and methods Thirty-one hemodialysis patients with suspected CRBSI were enrolled in this study. PCT level was measured at the time of presentation. Patients were divided into two groups according to blood culture results: positive and negative groups. PCT level and other markers for inflammation: white blood cell count (WBC), C-reactive protein (CRP), and ferritin were compared between the two groups. Statistical analysis of variables was performed using the t-test or Mann-Whitney test together with Spearman correlation test. Results Thirty-one patients had median age 44.7 ± 2.1 years. They comprised 16 males (52%) and 15 females (48%). Sixteen patients had a positive blood culture result while in 15 it was negative. PCT level was significantly higher in the positive blood culture group (40.0 ± -21.9) (95% confidence interval [CI] 28.4-51.8) while its level was 1.1 ± 1 (95% CI 0.54-1.8) in the negative blood culture group [t(15) = -7, p<0.001). In the positive culture group, there was a correlation between CRP and ferritin (r = -0.58, p = 0.01, n = 16), while no correlation between PCT and other markers of inflammation. Conclusions PCT is a useful marker for diagnosis of CRBSI among hemodialysis patients.

scholarly journals Bacterial and fungal profile, drug resistance pattern and associated factors of isolates recovered from blood samples of patients referred to Ethiopian Public Health Institute: cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Etsehiwot Adamu Tsegaye ◽  
Dejenie Shiferaw Teklu ◽  
Zelalem Tazu Bonger ◽  
Abebe Aseffa Negeri ◽  
Tesfaye Legesse Bedada ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Blood Stream Infections ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Blood Specimens

Abstract Background Blood stream infections are serious infections that usually induce prolongation of hospital stay, morbidity and mortality in several countries including Ethiopia. The aim of this study was to determine bacterial and fungal profile, their drug resistance patterns, and risk factors associated with blood stream infections. Methods A cross sectional study design was conducted from February 23 to June 23, 2020 at Ethiopian public health. A structured questionnaire was used to collect data on socio-demographic factors and clinical conditions. Blood specimens were analyzed using standard microbiological techniques. Antimicrobial susceptibility tests were performed using Kirby–Bauer disc diffusion technique and Vitek compact 2. Simple and multiple logistic regressions were used to assess the potential risk factors. Results A total of 175 pathogens isolated from 346 blood specimens. Of these, 60% Gram-negative bacteria, 30.86% Gram-positive bacteria and 9.14% fungal isolates were identified. Burkholderia cepacia and Coagulase negative staphylococcus were the predominant pathogen among Gram-negative and Gram-positive bacteria respectively. Among fungus, Candida krusei (56.25%) was the most predominant isolate. The highest proportions of antibacterial resistance were observed among 3rd generation cephalosporin and penicillin. Most fungal isolates expressed resistance to fluconazole. Sex (P = 0.007), age (P < 0.001) and use of invasive medical devices (P = 0.003) were identified as risk factors for bacterial blood stream infections. Conclusion The study showed high prevalence of blood stream infection was due to B. cepacia and non-C. albicans spp. This finding alarming ongoing investigation of blood stream infection is important for recognizing future potential preventive strategies including environmental hygiene and management of comorbid medical diseases to reduce the problem.

Depression and Cognitive Impairment in Patients on Hemodialysis: A cross-sectional study

2020 ◽  
Vol 5 (15) ◽  
pp. 185-192
Author(s):  
Nor Jannah Nasution Raduan ◽  
Mohd Razali Salleh ◽  
Ghazali Ahmad ◽  
Zaleha Ismail
Keyword(s):  
Cognitive Impairment ◽  
Publishing House ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Education Level ◽  
Sectional Study ◽  
Contributing Factors ◽  
Cross Sectional ◽  
Factors Associated ◽  
Low Education

Depression and cognitive impairment are the most common complications of patients on hemodialysis. The objective of this study is to identify contributing factors to depression and cognitive impairment in hemodialysis patients. This is a cross-sectional study involving 110 hemodialysis patients in Hospital Kuala Lumpur. The samples were recruited through universal sampling. Patients were assessed with the Beck Depression Inventory and Montreal Cognitive Assessment. This study found that 18.2% of patients had depression, and 48.2% had cognitive impairment. Factors associated with depression were unmarried status, low education level, and cognitive impairment. Factors associated with cognitive impairment were low education level, depression, and unemployment. Keywords: hemodialysis, depression, cognitive, ESRD eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v5i15.2468.

scholarly journals The correlation between uremic pruritus and blood lead levels in prevalent hemodialysis patients and its relation to the severity of pruritus using visual analog score

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Sahar Mahmoud Shawky ◽  
Reeham Abdel Aziz Abdel Hamid ◽  
Lina Essam Khedr
Keyword(s):  
Blood Lead ◽  
Cross Sectional Study ◽  
Hemodialysis Patients ◽  
Visual Analog Score ◽  
Blood Lead Levels ◽  
Cross Sectional ◽  
Uremic Pruritus ◽  
Significant Difference ◽  
Lead Levels ◽  
Group 2

Abstract Background Pruritus is a common and often distressing symptom in patients with chronic kidney disease. Though the pathogenesis of uremic pruritus remains poorly understood, systemic inflammation has presented itself as one of the possible explanations. High blood lead levels (BLLs) have been noted to be associated with inflammation and poor nutritional status in hemodialysis patients. Our aim is to study the relation between blood lead levels and uremic pruritus. This is a cross-sectional study that enrolled 50 patients; all were on regular hemodialysis 3 times per week for at least 6 months. Patients were divided into 2 groups, group 1 (n =10) with no pruritus and group 2 (n=40) with varying degrees of pruritus. Group 2 was further divided according to intensity of pruritus by visual analog score (VAS) into mild (n=10), moderate (n=20), and severe pruritus (n=10). Results There was a significant difference in serum lead levels and ferritin levels between groups 1 and 2 (p value < 0.01 and < 0.05, respectively). There was a statistically significant difference in serum lead levels in the groups with varying intensity of pruritus, having higher serum lead levels in patients who exhibited severe pruritus (p value < 0.005) Moreover, a statistically significant relation between elevated blood lead levels and the duration of dialysis was observed in this study. Conclusion Uremic pruritus is a multi-factorial phenomenon, and our study showed that blood lead levels in hemodialysis patients might be associated with increased intensity of pruritus.

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