RECURRENT INFECTION AND CATHETER LOSS IN PATIENTS ON CONTINUOUS AMBULATORY PERITONEAL DIALYSIS
|
|
- Margaret Fleming
- 6 years ago
- Views:
Transcription
1 Peritoneal Dialysis International, Vol. 19, pp Printed in Canada. All rights reserved /99 $ Copyright 1999 International Society for Peritoneal Dialysis RECURRENT INFECTION AND CATHETER LOSS IN PATIENTS ON CONTINUOUS AMBULATORY PERITONEAL DIALYSIS Roger Bayston, 1 Mark Andrews, 2 Keith Rigg, 2 and Andrew Shelton 1 Division of Microbiology, 1 University of Nottingham; Renal Unit, 2 City Hospital, Nottingham, United Kingdom Objective: To elucidate the factors leading to catheter loss from recurrent infection in patients on continuous ambulatory peritoneal dialysis (CAPD). Design: All catheters removed from patients were prospectively examined for infection. Setting: CAPD unit in large tertiary-care general hospital. Patients: Sixty-five consecutive patients undergoing catheter removal for whatever cause; 20 catheters rejected because of desiccation or contamination in transit. Interventions: None. Main Outcome Measures: Micro-organisms linked to catheter removal; their locations on removed catheters. Results: Of 45 catheters removed between January 1994 and August 1995, 26 were infected: 13/26 infections were caused by Staphylococcus aureus and 7/26 by Pseudomonas aeruginosa. In only one case was S. epidermidis associated with catheter removal. The most striking finding was that the inner cuff harbored large numbers of the infecting organisms, even when antibiotics had eradicated them from the peritoneal cavity and exit site, where present, and the catheter lumen. Conclusion: The importance of S. aureus and Ps. aeruginosa rather than S. epidermidis in catheter loss due to relapsing infection is confirmed. Persistence of the causative organisms in the inner cuff is a likely explanation for relapse after treatment, and might be due to the predominantly intraperitoneal administration of antibiotics. A clinical trial of the effect on catheter retention of empirical use of systemic or oral agents that give high tissue levels and are active against intracellular microorganisms, along with recommended intraperitoneal regimens, is indicated. Correspondence to: R. Bayston, Biomaterials-Related Infection Group, University of Nottingham Division of Microbiology & Infectious Diseases, City Hospital, Nottingham NG5 1PB United Kingdom. Received 5 February 1999; accepted 21 September KEY WORDS: Catheter loss; peritonitis; cuff infection; treatment; relapse. Continuous ambulatory peritoneal dialysis (CAPD) is widely accepted as first-line treatment for endstage renal disease, with beneficial impact on quality of life. However, although the number of patients on CAPD is increasing worldwide, there is a better method survival for hemodialysis than CAPD, the difference being due mainly to peritonitis (1). Despite innovations and improvements in CAPD, peritonitis and exit-site infection remain a problem, resulting in significant morbidity and mortality (2,3) and having considerable financial and other resource implications (4). The incidence of peritonitis varies, but a rate of between 1.1 and 1.3 patient-episodes per year has been reported (5). Exit-site infections also vary in incidence: a rate of 0.76 patient-episodes per year has been reported (6). The causative organism is a major factor in determining outcome (7,8). Most infections (40% 60%) are caused by coagulase-negative staphylococci (CoNS), with about 10% each being due to Staphylococcus aureus and gram-negative bacilli, particularly Pseudomonas aeruginosa, and this has led to a concentration of research effort on CoNS. Treatment of CAPD peritonitis usually follows various published guidelines, such as those of the Advisory Committee on Peritonitis Management of the International Society for Peritoneal Dialysis (5,9,10) and the Working Party of the British Society for Antimicrobial Chemotherapy (BSAC) (11), but relapse remains a serious problem that may lead to catheter removal and transfer to hemodialysis. Catheter loss is therefore seen as a major adverse outcome, and the reasons for relapsing infection merit further study. We have therefore prospectively collated clinical data and systematically examined catheters from a consecutive series of patients undergoing catheter removal for any reason in order to elucidate factors leading to relapse of infection and consequent catheter loss. PATIENTS AND METHODS From January 1994 to August 1995, all catheters removed for any reason were examined systematically for infection. The catheters were removed by
2 PDI NOVEMBER 1999 VOL. 19, NO. 6 INFECTION AND CATHETER LOSS reopening the midline incision and dissecting free the inner cuff. The inner portion of the catheter was then cut from the remainder and removed through the incision. The outer cuff was then released from the subcutaneous tissues from the inside. Complete catheters were sent to the laboratory in sterile sealed double transport bags and refrigerated until examined, which was always within 24 hours and usually within 2 hours. The catheters were examined while still in the transparent inner bags, and to minimize chances of contamination they were sampled through incisions made in the bag after preparation of its outer surface with an isopropanol antiseptic swab. The 2-cm segment bearing the inner cuff was excised using a sterile scalpel and the cuff rolled on the surface of a blood agar plate and then onto a sterile microscope slide before being fixed in buffered glutaraldehyde for scanning electron microscopy (SEM). Slides were stained by Gram s method and examined for neutrophils and organisms. The fluid in the catheter lumen proximal to the cuff was sampled by aseptic flushing and aspiration, and the fluid inoculated onto a blood agar plate and into a brain-heart infusion fluid medium (BHI, Oxoid, Basingstoke, England). One drop of the remaining fluid was placed on a microscope slide and stained and examined as above. All plate cultures were incubated for 48 hours at 37 C. The BHI was subcultured after 24 hours (48 hours if clear) onto a blood agar plate. A segment of unflushed catheter was fixed in glutaraldehyde for SEM. All isolates were identified using API (biomérieux, Basingstoke, England) and their antibiograms determined by disc diffusion. Clinical data relating to infection history (peritonitis and exit-site infection episodes) and treatment prior to catheter removal were recorded. RESULTS During the study period, 65 catheters were received. Twenty of these were not examined because of desiccation or contamination in transit, or because they were incomplete (no inner cuff sent, etc). A total of 45 catheters were therefore examined: 26 had been removed because of recurrent or persistent infection, 8 following successful renal transplantation, 10 for catheter blockage or CAPD failure unrelated to infection, and 1 following a diverticular abscess and perforation. The time elapsed from diagnosis of infection to catheter removal ranged from 16 to 96 days (mean 56 days) for peritonitis due to S. aureus, from 2 to 120 days (mean 78 days) for exit-site infection only, and from 80 to 210 days (mean 128 days) for exitsite infection with peritonitis due to this organism. Pseudomonas exit-site infection in the absence of peritonitis was diagnosed between 6 and 60 days (mean 35 days) prior to catheter removal; there were insufficient pseudomonas infections to allow analysis of cases with peritonitis. Of the 18 catheters removed for reasons other than infection, such as renal transplant, technical or mechanical failure, or noncompliance, 11 grew no organisms from either catheter lumen or cuff and a further 4 gave insignificant growth from one or the other site. Three gave growth that was possibly significant from both sites. In one case (case 24), the catheter was removed because it was blocked, but there was a history of recurrent abdominal pain with insignificant white cell counts on bag fluid examination, and CoNS was isolated sporadically on several occasions over the preceding 6 months. On examination of the removed catheter, while no polymorphs were seen in either the luminal flush fluid or the cuff, both grew 50 colonies of Ps. aeruginosa. In the second case (case 53), the catheter was removed following a renal transplant but the removal was prompted by peritonitis (effluent WBC 8500/mm 3 ) although no organisms were isolated. Vancomycin and flucloxacillin had been given. On examination of the removed catheter, the luminal flush fluid showed many polymorphs and pleomorphic gram-negative bacilli, as did the cuff. Fifteen and five colonies respectively of Ps. aeruginosa were isolated from fluid and cuff. In a third case (case 34) in which the catheter was removed because it had ceased to function, a heavy pure growth of S. simulans was isolated from both lumen and cuff. Many polymorphs were seen in both sites on microscopy. This patient had had Acinetobacter peritonitis 5 months previously, but no infection with S. simulans or any other CoNS had been recorded. Of the 26 patients whose catheters had been removed because of infection (Tables 1 and 2), 11 had exit-site infections only, 7 had peritonitis without exitsite infection, and 8 had exit-site infections followed by peritonitis. None had a clinical tunnel infection. In those patients who had had clinical exit-site infection due to S. aureus or Ps. aeruginosa (17 cases), all had received an appropriate oral antibiotic (usually flucloxacillin for S. aureus and ciprofloxacin for Ps. aeruginosa) for at least 10 days. At the time of catheter removal, the exit-site infection had resolved clinically in 9 of these patients (53%) despite a heavy growth of S. aureus or Ps. aeruginosa from the cuff on removal. Twenty of the 26 cases were caused by either S. aureus (46%) or Ps. aeruginosa (27%). The patient with peritonitis due to Corynebacterium sp also had an inflamed exit site, although no organisms were grown from this site. Similarly, the patient with viridans streptococcus peritonitis also had a clinically infected exit site from which no organisms were isolated. During the 19 months of the study, there were 551
3 BAYSTON et al. NOVEMBER 1999 VOL. 19, NO. 6 PDI TABLE 1 Clinically Involved Sites in Patients Whose Catheters Were Removed Because of Infection Causative organism N Exit site only Peritonitis only Both Staphylococcus aureus Pseudomonas aeruginosa Corynebacterium sp Candida albicans 1 1 Viridans streptococcus 1 1 Aspergillus niger 1 1 Staphylococcus epidermidis 1 1 TABLE 2 Results of Catheters Removed Because of Infection Case Organism isolated previously Catheter lumen Cuff 1 Staphylococcus aureus NG 40 colonies, S. aureus 4 S. aureus 3 colonies, S. aureus HPG, S. aureus 9 S. aureus 4 colonies, S. aureus MPG, S. aureus 10 S. aureus NG 28 colonies, S. aureus 12 S. aureus 1 colony, S. aureus HPG, S. aureus 13 S. aureus 3 colonies, S. aureus MPG, S. aureus 26 S. aureus 100 colonies, S. aureus MPG, S. aureus 31 S. aureus 25 colonies, S. aureus MPG, S. aureus 41 S. aureus 2 colonies, S. aureus MPG, S. aureus 48 S. aureus NG NG 50 S. aureus NG NG 61 S. aureus 12 colonies, S. aureus HPG, S. aureus 62 S. aureus NG MPG, S. aureus 2 Pseudomonas aeruginosa NG HPG, Ps. aeruginosa 17 Ps. aeruginosa 3 colonies, Ps. aeruginosa HPG, Ps. aeruginosa 27 Ps. aeruginosa NG NG 29 Ps. aeruginosa NG NG 30 Ps. aeruginosa 25 colonies, Ps. aeruginosa HPG, Ps. aeruginosa 40 Ps. aeruginosa NG NG 58 Ps. aeruginosa HPG, Ps. aeruginosa HPG, Ps. aeruginosa 16 Corynebacterium striatum 12 colonies, C. striatum MPG, C. striatum 49 Corynebacterium sp NG NG 5 Candida albicans MPG, C. albicans MPG, C. albicans 20 Viridans streptococcus NG HPG, Vir Strep 60 Aspergillus niger HPG, A. niger NG 64 S. epidermidis NG NG NG = no growth; HPG = heavy pure growth (approximately colony forming units/ml); MPG = moderate pure growth (approximately cfu/ml). 65 cases of peritonitis due to CoNS, but only 1 patient with persistent S. epidermidis peritonitis had to have his catheter removed. In this case, four relapses had occurred; the patient was an elderly diabetic with poor compliance and he was transferred to hemodialysis. Gram film results were consistent with the culture results. No organisms were seen in lumen fluids from cases 1, 2, 4, 9, 10, 12, 13, 16, 17, 20, 30, 31, 41, 61, and 62 although they were seen in the Gram films of the respective cuffs (Figure 1). Most of the organisms were intracellular. Scanning electron microscopy of the cuffs revealed a mesh of Dacron fibers heavily infiltrated by fibrin (Figure 2). Only very occasional bacteria were detected by this method (Figure 3), presumably because the majority were intracellular as shown by Gram stain. DISCUSSION Significant growth was unexpectedly obtained from both catheter and cuff in 3 patients thought not to be 552
4 PDI NOVEMBER 1999 VOL. 19, NO. 6 INFECTION AND CATHETER LOSS Figure 1 Gram film of smear of removed inner cuff showing neutrophils and gram-positive cocci (Staphylococcus aureus), mainly intracellular (144 ). Cocci show varying states of cell wall integrity and appear in slightly different focal planes. Figure 2 Scanning electron micrograph of a removed inner cuff showing Dacron fibers and dense host-derived infiltrate (240 ). infected (cases 24, 34, and 53). In cases 24 and 53, peritonitis had been suspected prior to catheter removal for other reasons in one case on the grounds of intermittent abdominal pain and in the other because of a high WBC count in the effluent but no growth was obtained on culture. In the third case infection had not been suspected. In those 26 patients whose catheters were removed because of persistent infection due to S. aureus or Ps. aeruginosa, 17 had had exit-site infections, 9 of which had resolved clinically on treatment before Figure 3 Scanning electron micrograph of a removed inner cuff showing fibrinous infiltrate, red blood cells, phagocytes, and a single extracellular coccus (6000 ). catheter removal. Seven more did not have a recorded exit-site infection but had relapsing peritonitis. While the prognosis of exit-site infections is well known (12), the problem of clinically inapparent infection of the cuff is not well documented. However, Korzets et al. (13) carried out an ultrasound study of patients with CAPD peritonitis without clinical exit-site or tunnel infection in order to determine the relationship between clinically inapparent tunnel infection and peritonitis. In 13 of 16 episodes of peritonitis, extraperitoneal infection was found to be localized to the internal cuff of the Tenckhoff catheter. Of the 26 infections leading to catheter removal, only 1 was due to S. epidermidis. While a great deal of attention has been paid to this group of organisms, and while they account for a high proportion of cases of CAPD peritonitis, they are associated with relatively mild symptoms and generally do not lead to catheter loss. Our findings are consistent with those of other researchers, in that the major problems in CAPD infection in terms of outcome are S. aureus and Ps. aeruginosa. Sixteen of the 26 catheters (62%) removed for infection had significantly greater numbers of bacteria in the cuff than in the catheter lumen, 11 having either no growth or fewer than 5 colonies from the latter site. In two cases (5 and 58) the lumen and the cuff each gave heavy or moderate growth, in one case of Ps. aeruginosa and in the other of Candida albicans. The patient in case 58 had had pseudomonas peritonitis that had not responded to treatment by the time the catheter was removed, and large numbers of bacteria were grown from the effluent preoperatively. In case 5, a variety of antibiotics had been administered 553
5 BAYSTON et al. NOVEMBER 1999 VOL. 19, NO. 6 PDI 554 over the previous 2 years for a series of CAPD infections due to both gram-positive and gram-negative bacteria. Candida had been isolated intermittently for 8 months prior to catheter removal, and on examination the catheter lumen was almost completely occluded by the fungus. National guidelines for the treatment of CAPD peritonitis have two main aims: to target the most likely bacteria, and to avoid systemic toxicity in the absence of renal excretory function. Both the BSAC guidelines (11) and the updated Advisory Committee recommendations (5) suggest initial empirical treatment that is intended to cover both gram-positive and gram-negative bacteria. In the first of these, administration of a combination of vancomycin and an aminoglycoside, both intraperitoneally, is recommended, while in the second report administration of a first-generation cephalosporin and an aminoglycoside, also intraperitoneally, are suggested in view of concern over vancomycin resistance. In both cases, modification is recommended in the light of culture results. The 1996 Update (5) recommends addition of rifampicin for S. aureus infections if clinical response is less than desired. However, this can be misleading, because eradication of peritonitis, and even also an accompanying exit-site infection, does not necessarily indicate eradication of an undetected inner-cuff infection. In the 1998 Update (10), which deals mainly with exit-site infections, rifampicin is recommended for severe-appearing infections or if there is no improvement on initial therapy. The agents currently recommended by both BSAC (11) and the Advisory Committee (5) for pseudomonas peritonitis are intraperitoneal aminoglycoside and ceftazidime. The patients in our series were treated broadly according to these guidelines except that intraperitoneal vancomycin (50 mg/l in a 2-L bag) was still the preferred treatment for peritonitis due to gram-positive bacteria. Our results show that the two bacteria, S. aureus and Ps. aeruginosa, mainly responsible for CAPD infection leading to catheter loss had been eradicated from the peritoneal cavity and from the catheter lumen, but that they persisted in large numbers in the cuff. The Dacron material from which the cuff is made is designed to encourage ingrowth of fibroblasts in order to anchor the catheter and to prevent migration of bacteria along the tunnel. Unfortunately the infiltrated cuff also provides an ideal environment for these bacteria, consisting of biomaterial with host cells and avascular connective tissue (Figure 2). Large numbers of bacteria have been reported previously in the inner cuff of catheters removed from 3 patients with S. aureus exit-site infections (14). Microbial biofilms in the catheter lumen have also been incriminated (15) although the luminal surfaces were clear of biofilm in our study, possibly because of repeated attempts at intraperitoneal treatment. The treatment regimens for CAPD peritonitis are intended to concentrate antibiotic activity in the catheter lumen and the peritoneal cavity and, if possible, to avoid systemic and therefore tissue levels. Agents such as intraperitoneal cefazolin, one of those recommended by the guidelines, give plasma concentrations many times higher than the minimum inhibitory concentration for S. aureus (16), but they fail to penetrate phagocytic cells, unlike rifampicin which is concentrated within neutrophils and macrophages (17). We consider that the nature and microenvironment of the cuff and the principle of the treatment regimen are responsible for persistence of the bacteria in the cuff, giving rise to relapse, treatment failure, and ultimately to catheter loss. While in some cases a clinical exit-site or tunnel infection would indicate such a problem, this is by no means always evident. The BSAC report does not address exit-site or tunnel infection; indeed it states that, in cases of peritonitis, infection is usually confined to the peritoneal cavity. The 1996 Update does recommend, for patients with S. aureus infection who fail to respond, re-evaluation specifically for an occult tunnel infection. Recommended procedures include ultrasonography, computed tomography scanning, or gallium scanning. In the light of our results we would recommend that, at least in S. aureus and Ps. aeruginosa peritonitis, a cuff infection should be assumed to be present, and oral or systemic agents aimed at achieving therapeutic tissue levels and active against intracellular bacteria should be included in the first-line treatment strategy. On the basis of our findings, we now plan to carry out a clinical trial to determine whether catheter loss can be reduced by treatment aimed at eradication of subclinical internal cuff infection. ACKNOWLEDGMENTS We are grateful to the nursing staff of the CAPD Unit, City Hospital, Nottingham, for their valuable assistance in collection of removed catheters, and to the consultants in renal medicine who allowed us to study their patients. The study was supported financially by the Wade Charitable Trust. REFERENCES 1. Maiorca R, Cancarini GC, Zubani R, Camerini C, Manili L, Brunori G, et al. CAPD viability: a long-term comparison with hemodialysis. Perit Dial Int 1996; 16: Digenis GE, Abraham G, Savin E, Blake P, Dombros N, Sombolos K, et al. Peritonitis-related deaths in con-
6 PDI NOVEMBER 1999 VOL. 19, NO. 6 INFECTION AND CATHETER LOSS tinuous ambulatory peritoneal dialysis (CAPD) patients. Perit Dial Int 1990; 10: Tzamaloukas AH, Murata GH, Fox L. Peritoneal catheter loss and death in continuous ambulatory peritoneal dialysis peritonitis: correlation with clinical and biochemical parameters. Perit Dial Int 1993; 13(Suppl 2):S Woodrow G, Turney JH, Brownjohn AM. Technique failure in peritoneal dialysis and its impact on patient survival. Perit Dial Int 1997; 17: Keane WF, Alexander SR, Bailie GR, Boeschoten E, Gokal R, Golper TA, et al. Peritoneal dialysis-related peritonitis treatment recommendations: 1996 update. Perit Dial Int 1996; 16: Hasbargen BJ, Rodgers DJ, Hasbargen JA, Quinn MJ, James MK. Exit-site care is it time for a change? Perit Dial Int 1993; 13(Suppl 2):S Bunke CM, Brier ME, Golper TA. Pseudomonas peritonitis in peritoneal dialysis patients: the Network 9 peritonitis study. Am J Kidney Dis 1995; 25: Golper TA, Brier ME, Bunke CM, Schreiber MJ, Bartlett DK, Hamilton RW, et al. Risk factors for peritonitis in chronic peritoneal dialysis: the Network 9 peritonitis and catheter survival studies. Am J Kidney Dis 1996; 28: Gokal R, Ash SR, Helfrich BG, Holmes CJ, Joffe P, Nichols W, et al. Peritoneal catheters and exit-site practices: toward an optimum peritoneal access. Perit Dial Int 1993; 13: Gokal R, Alexander S, Ash S, Chen TW, Danielson A, Holmes C, et al. Peritoneal catheters and exit-site practices: toward an optimum peritoneal access: 1998 update. Perit Dial Int 1998; 18: Report of a Working Party of the British Society for Antimicrobial Chemotherapy. Diagnosis and management of peritonitis in continuous ambulatory peritoneal dialysis. Lancet 1987; i: Gupta B, Bernardini J, Piraino B. Peritonitis associated with exit site and tunnel infections. Am J Kidney Dis 1996; 28: Korzets Z, Erdberg A, Golan E, Ben-Chitrit S, Verner M, Rathus V, et al. Frequent involvement of the internal cuff segment in CAPD peritonitis and exit-site infection an ultrasound study. Nephrol Dial Transplant 1996; 11: Marrie TJ, Noble M, Costerton JW. Examination of the morphology of bacteria adhering to peritoneal dialysis catheters by scanning and transmission electron microscopy. J Clin Microbiol 1983; 18: Dasgupta MK, Bettcher KB, Ulan RA, Burns V, Lam K, Dossetor JB, et al. Relationship of adherent bacterial biofilms to peritonitis in chronic ambulatory peritoneal dialysis. Perit Dial Bull 1987; 7: Manley HJ, Bailie GR, Asher RD, Eisele G, Frye RF. Pharmacokinetics of intermittent intraperitoneal cefazolin in continuous ambulatory peritoneal dialysis patients. Perit Dial Int 1999; 19: Prokesch RC, Hand WL. Antibiotic entry into human polymorphonuclear leukocytes. Antimicrob Agents Chemother 1982; 21:
OUTCOME FOLLOWING CAPD-ASSOCIATED GRAM-NEGATIVE PERITONITIS
66 OUTCOME FOLLOWING CAPD-ASSOCIATED GRAM-NEGATIVE PERITONITIS CHIA-SHENG CHEN, SHYI-YU CHUNG, WEN-LIANG YU*, MING-TZUNG KAO Peritonitis remains the leading cause of patient dropout from peritoneal dialysis
More informationPresternal Catheter Design An Opportunity to Capitalize on Catheter Immobilization
Advances in Peritoneal Dialysis, Vol. 26, 2010 Dale G. Zimmerman Presternal Catheter Design An Opportunity to Capitalize on Catheter Immobilization Effective immobilization of the peritoneal catheter has
More informationImaging of Peritoneal Catheter Tunnel Infection Using Positron-Emission Tomography
Advances in Peritoneal Dialysis, Vol. 26, 2010 Pooja Singh, 1,2 Brenda Wiggins, 1 Yijuan Sun, 1,2 Karen S. Servilla, 1,2 Reuben E. Last, 3,4 Michael F. Hartshorne, 5,6 Antonios H. Tzamaloukas 1,2 Imaging
More information5. Indications for the use of urokinase in peritoneal dialysis associated peritonitis
5. Indications for the use of urokinase in peritoneal dialysis associated peritonitis Date written: February 2003 Final submission: July 2004 Guidelines (Include recommendations based on level I or II
More informationCentral Venous Access Devices and Infection
Central Venous Access Devices and Infection Dr Andrew Daley Microbiology & Infectious Diseases Women s & Children s Health Melbourne Background Types of infection! Local site infection! Blood stream infection!
More informationManagement of Catheter Related Bloodstream Infection (CRBSI), including Antibiotic Lock Therapy.
Management of Catheter Related Bloodstream Infection (CRBSI), including Antibiotic Lock Therapy. Written by: Dr K Gajee, Consultant Microbiologist Date: June 2017 Approved by: Drugs & Therapeutics Committee
More informationPERSISTENT SYMPTOMATIC INTRA-ABDOMINAL COLLECTION AFTER CATHETER REMOVAL FOR PD-RELATED PERITONITIS
Peritoneal Dialysis International, Vol. 31, pp. 34-38 doi:10.3747/pdi.2009.00185 0896-8608/11 $3.00 +.00 Copyright 2011 International Society for Peritoneal Dialysis PERSISTENT SYMPTOMATIC INTRA-ABDOMINAL
More informationPredictive Value of Dialysate Cell Counts in Peritonitis Complicating Peritoneal Dialysis
Predictive Value of Dialysate Cell Counts in Peritonitis Complicating Peritoneal Dialysis Kai Ming Chow,* Cheuk Chun Szeto,* Kitty Kit-Ting Cheung,* Chi Bon Leung,* Sunny Sze-Ho Wong, Man Ching Law,* Yiu
More informationInternational Journal of Infectious Diseases
International Journal of Infectious Diseases 14 (2010) e489 e493 Contents lists available at ScienceDirect International Journal of Infectious Diseases journal homepage: www.elsevier.com/locate/ijid Peritoneal
More informationOutcomes of Peritonitis in Children on Peritoneal Dialysis: A 25-Year Experience at Severance Hospital
Original Article http://dx.doi.org/10.3349/ymj.2013.54.4.983 pissn: 0513-5796, eissn: 1976-2437 Yonsei Med J 54(4):983-989, 2013 Outcomes of Peritonitis in Children on Peritoneal Dialysis: A 25-Year Experience
More informationStaphylococci. Gram stain: gram positive cocci arranged in clusters.
Microbiology lab Respiratory system Third medical year Lab contents: Gram positive bacteria (Staphylococcus and Streptococcus spp), two types of filamentous fungi (Aspergillus and Penicillium spp), and
More informationNephrology. ABC Fax Marie Philipneri Ziyad Al Aly Kamal Amin Mary E. Gellens Bahar Bastani
American Journal of Nephrology Original Article: Patient-Oriented, Translational Research Am J Nephrol 2003;23:202 207 DOI: 10.1159/000071479 Received: April 1, 2003 Accepted: April 9, 2003 Published online:
More informationAlthough long-term outcomes of hemodialysis and
Peritoneal Dialysis International, Vol. 31, pp. 39-47 doi:10.3747/pdi.2009.00235 0896-8608/11 $3.00 +.00 Copyright 2011 International Society for Peritoneal Dialysis SIMILAR PERITONITIS OUTCOME IN CAPD
More informationMicrobiology Risk Factors and Outcomes of Peritonitis in Tunisian Peritoneal Dialysis Patients
Original Article World J Nephrol Urol. 2018;7(2):45-52 Microbiology Risk Factors and Outcomes of Peritonitis in Tunisian Peritoneal Dialysis Patients Lilia Ben Lasfar a, b, Yosra Guedri a, Awatef Azzebi
More informationPART FIVE. Catheters and Connectors
PART FIVE Catheters and Connectors Advances in Peritoneal Dialysis, Vol. 19, 2003 Krishna M. Sahu, Aziz Walele, Vasilis Liakopoulos, Joanne M. Bargman Analysis of Factors Predicting Survival of a Second
More informationA new selective blood agar medium for Streptococcus pyogenes and other haemolytic streptococci
J. clin. Path. (1964), 17, 231 A new selective blood agar medium for Streptococcus pyogenes and other haemolytic streptococci E. J. L. LOWBURY, A. KIDSON, AND H. A. LILLY From the Medical Research Council
More informationWork up of Respiratory & Wound Cultures:
Work up of Respiratory & Wound Cultures: Culture work up 2 Systematic approaches 1 Work up of Respiratory & Wound Cultures Resident flora Colonizing organisms Pathogens 2 Work up of Respiratory & Wound
More informationPharmacokinetics of Once Daily Intraperitoneal Cefazolin in Continuous Ambulatory Peritoneal Dialysis Patients
J Am Soc Nephrol 11: 1117 1121, 2000 Pharmacokinetics of Once Daily Intraperitoneal Cefazolin in Continuous Ambulatory Peritoneal Dialysis Patients CHAI LUAN LOW,* KAMANI GOPALAKRISHNA,* and WAI CHOONG
More informationUrine bench. John Ferguson Sept 2013
Urine bench John Ferguson Sept 2013 Overview Specimen collection- separate presentation Urinalysis: protein, blood, white cells, nitrite Microscopy- crystals and casts- separate presentations quantitative
More informationSterility Testing of Peripheral Blood Stem cell (PBSC) harvests in a Tertiary Oncology Setup
Sterility Testing of Peripheral Blood Stem cell (PBSC) harvests in a Tertiary Oncology Setup Bankar S 1, Tirlotkar A 1, Ojha S 1, Bhat V 2,Kannan S 3, Rajadhyaksha S 1 1. Department of Transfusion Medicine,
More information02/10/2017. Major Infectious Complications. Learning Objectives. Modalities. At the end of this session the listener will be able to:
Major Infectious Complications Alicia M Neu, MD Chief, Division of Pediatric Nephrology Medical Director, Pediatric Dialysis and Kidney Transplantation The Johns Hopkins University School of Medicine The
More informationHaemodialysis central venous catheter-related sepsis management guideline Version 3. NAME M. Letheren Chair Clinical Effectiveness Advisory Group
Lancashire Teaching Hospitals NHS Foundation Trust Haemodialysis central venous catheter-related sepsis management guideline Version 3 AUTHOR APPROVED BY DATE AUTH REF. NO NAME REBG/00018/July12 Michael
More informationMANAGEMENT OF HAEMODIALYSIS CATHETER RELATED BLOOD STREAM INFECTION
MANAGEMENT OF HAEMODIALYSIS CATHETER RELATED BLOOD STREAM INFECTION RRCV CMG Renal and Transplant Service 1. Introduction Catheter related blood stream infection (CR-BSI) is a common complication in patients
More informationBlood culture 壢新醫院 病理檢驗科 陳啟清技術主任
Blood culture 壢新醫院 病理檢驗科 陳啟清技術主任 A Positive Blood Culture Clinically Important Organism Failure of host defenses to contain an infection at its primary focus Failure of the physician to effectively eradicate,
More informationPatients with underlying liver disease and ascites are
Peritoneal Dialysis International, Vol. 26, pp. 213 217 Printed in Canada. All rights reserved. 0896-8608/06 $3.00 +.00 Copyright 2006 International Society for Peritoneal Dialysis CONTINUOUS AMBULATORY
More informationLab 4. Blood Culture (Media) MIC AMAL-NORA-ALJAWHARA 1
Lab 4. Blood Culture (Media) 2018 320 MIC AMAL-NORA-ALJAWHARA 1 Blood Culture 2018 320 MIC AMAL-NORA-ALJAWHARA 2 What is a blood culture? A blood culture is a laboratory test in which blood is injected
More informationDialysis Event Protocol
Dialysis Event Protocol Introduction In 2009, more than 370,000 patients were treated with maintenance hemodialysis in the United States. 1 Hemodialysis patients require a vascular access, which can be
More information320 MBIO Microbial Diagnosis. Aljawharah F. Alabbad Noorah A. Alkubaisi 2017
320 MBIO Microbial Diagnosis Aljawharah F. Alabbad Noorah A. Alkubaisi 2017 Blood Culture What is a blood culture? A blood culture is a laboratory test in which blood is injected into bottles with culture
More informationInfective endocarditis
Infective endocarditis Today's lecture is about infective endocarditis, the Dr started the lecture by asking what are the most common causative agents of infective endocarditis? 1-Group A streptococci
More informationPichaya Tantiyavarong, 1,2 Opas Traitanon, 2 Piyatida Chuengsaman, 3 Jayanton Patumanond, 1 and Adis Tasanarong Introduction
International Nephrology Volume 2016, Article ID 6217135, 8 pages http://dx.doi.org/10.1155/2016/6217135 Research Article Dialysate White Blood Cell Change after Initial Antibiotic Treatment Represented
More informationDiagnostic approach and microorganism resistance pattern in UTI Yeva Rosana, Anis Karuniawati, Yulia Rosa, Budiman Bela
Diagnostic approach and microorganism resistance pattern in UTI Yeva Rosana, Anis Karuniawati, Yulia Rosa, Budiman Bela Microbiology Department Medical Faculty, University of Indonesia Urinary Tract Infection
More information320 MBIO Microbial Diagnosis. Aljawharah F. Alabbad Noorah A. Alkubaisi 2017
320 MBIO Microbial Diagnosis Aljawharah F. Alabbad Noorah A. Alkubaisi 2017 Pathogens of the Urinary tract The urinary system is composed of organs that regulate the chemical composition and volume of
More informationDialysis-associated peritonitis in children
Pediatr Nephrol (2010) 25:425 440 DOI 10.1007/s00467-008-1113-6 EDUCATIONAL REVIEW Dialysis-associated peritonitis in children Vimal Chadha & Franz S. Schaefer & Bradley A. Warady Received: 15 August 2008
More informationPeritoneal Fluid Analysis and Result Interpretation: Implications for Nursing Care
Annual Dialysis Conference Dallas, TX March 16-19, 2019 Peritoneal Fluid Analysis and Result Interpretation: Implications for Nursing Care Isaac Teitelbaum, MD Professor of Medicine Director, Home Dialysis
More information18/03/2014 PD: INFECTIOUS COMPLICATIONS. Infectious complications in PD patients. Some facts. Exit site infection. Tunnel infection.
PD: INFECTIOUS COMPLICATIONS Pr Max Dratwa Honorary consultant, Nephrology-Dialysis CHU Brugmann Université Libre de Bruxelles Infectious complications in PD patients Some facts Exit site infection Tunnel
More informationThe Physiology of Peritoneal Dialysis As Related To Drug Removal
The Physiology of Peritoneal Dialysis As Related To Drug Removal Thomas A. Golper, MD, FACP, FASN Vanderbilt University Medical Center Nashville, TN thomas.golper@vanderbilt.edu Clearance By Dialysis Clearance
More informationObjectives 12/4/2013. Disclosure. Culture of Orthopaedic Infections. Microbiology Testing in the Diagnosis of Prosthetic Joint Infections
Culture of Orthopaedic Infections Microbiology Testing in the Diagnosis of Prosthetic Joint Infections December 9, 2013 Raymond P. Podzorski, Ph.D., D(ABMM) Clinical Microbiologist ProHealth Care Laboratories
More informationURINARY TRACT INFECTIONS 3 rd Y Med Students. Prof. Dr. Asem Shehabi Faculty of Medicine, University of Jordan
URINARY TRACT INFECTIONS 3 rd Y Med Students Prof. Dr. Asem Shehabi Faculty of Medicine, University of Jordan Urinary Tract Infections-1 Normal urine is sterile.. It contains fluids, salts, and waste products,
More informationAcceptability of Sputum Specimens
JOURNAL OF CLINICAL MICROBIOLOGY, Oct. 1982, p. 627-631 0095-1137/82/100627-05$02.00/0 Copyright C 1982, American Society for Microbiology Vol. 16, No. 4 Comparison of Six Different Criteria for Judging
More informationUrinary tract infections
بسم رلاهللا Urinary tract infections This sheet will only contain extra notes said by the dr. UTIs: - is the second most common type of infections in community(second only to RTIs) - Incidence=20-30% of
More informationVentriculoperitoneal shunt infection in Haji Adam Malik Hospital, Medan
Ventriculoperitoneal shunt infection in Haji Adam Malik Hospital, Medan R Dharmajaya Head department of neurosurgery, faculty medicine of Sumatera Utara University E-mail: Abstract.Ventriculoperitoneal
More informationANWICU knowledge
ANWICU knowledge www.anwicu.org.uk This presenta=on is provided by ANWICU We are a collabora=ve associa=on of ICUs in the North West of England. Permission to provide this presenta=on has been granted
More informationFrequency of Nasal Carriage of Staphylococcus Aureus and Its Antimicrobial Resistance Pattern in Patients on Hemodialysis
Dialysis Frequency of Nasal Carriage of Staphylococcus Aureus and Its Antimicrobial Resistance Pattern in Patients on Hemodialysis Roya Ghasemian, 1 Narges Najafi, 1 Atieh Makhlough, 2 Mohammad Khademloo
More informationSIMULTANEOUS CATHETER REPLACEMENT FOR INFECTIOUS AND MECHANICAL COMPLICATIONS WITHOUT INTERRUPTION OF PERITONEAL DIALYSIS
Peritoneal Dialysis International, Vol. 36, pp. 182 187 www.pdiconnect.com 0896-8608/16 $3.00 +.00 Copyright 2016 International Society for Peritoneal Dialysis SIMULTANEOUS CATHETER REPLACEMENT FOR INFECTIOUS
More informationInfective Endocarditis Empirical therapy Antibiotic Guidelines. Contents
Infective Endocarditis Empirical therapy Antibiotic Guidelines Classification: Clinical Guideline Lead Author: Antibiotic Steering Group Additional author(s): as above Authors Division: Division of Clinical
More informationEvaluation of Antibacterial Effect of Odor Eliminating Compounds
Evaluation of Antibacterial Effect of Odor Eliminating Compounds Yuan Zeng, Bingyu Li, Anwar Kalalah, Sang-Jin Suh, and S.S. Ditchkoff Summary Antibiotic activity of ten commercially available odor eliminating
More informationStudy of etiological factors and sensitivity pattern in CSOM
Indian Journal of Basic and Applied Medical Research; December 2015: Vol.-5, Issue- 1, P. 766-770 766-771 Original article: Study of etiological factors and sensitivity pattern in CSOM Paresh Chavan, G
More informationA Multicentre Study about Pattern and Organisms Isolated in Follow-up Blood Cultures
Ann Clin Microbiol Vol., No., March, 0 http://dx.doi.org/0./acm.0... ISSN -0 A Multicentre Study about Pattern and Organisms Isolated in Follow-up Blood Cultures Jeong Hwan Shin, Eui Chong Kim, Sunjoo
More informationUTI IN ELDERLY. Zeinab Naderpour
UTI IN ELDERLY Zeinab Naderpour Urinary tract infection (UTI) is the most frequent bacterial infection in elderly populations. While urinary infection in the elderly person is usually asymptomatic, symptomatic
More informationAilyn T. Isais-Agdeppa, MD*, Lulu Bravo, MD*
A FIVE-YEAR RETROSPECTIVE STUDY ON THE COMMON MICROBIAL ISOLATES AND SENSITIVITY PATTERN ON BLOOD CULTURE OF PEDIATRIC CANCER PATIENTS ADMITTED AT THE PHILIPPINE GENERAL HOSPITAL FOR FEBRILE NEUTROPENIA
More informationThe CARI Guidelines Caring for Australians with Renal Impairment. Guidelines
6. Type of peritoneal dialysis Date written: February 2003 Final submission: May 2004 Guidelines No peritoneal dialysis has proven to be superior to the two cuff standard Tenckhoff in the prevention of
More informationArglaes provides a seven-day, non-cytotoxic barrier against infection
Arglaes provides a seven-day, non-cytotoxic barrier against infection Arglaes Controlled-Release Silver Technology Reduce bioburden with Arglaes Silver Barrier Dressings Antimicrobial Arglaes began the
More informationSerum C-reactive protein concentration in the
J Clin Pathol 1985;38:459-463 Serum C-reactive protein concentration in the management of infection in patients treated by continuous ambulatory peritoneal dialysis CRK HIND,* SP THOMSON,t CG WINEARLS,t
More informationReceived 30 March 2005; returned 16 June 2005; revised 8 September 2005; accepted 12 September 2005
Journal of Antimicrobial Chemotherapy (2005) 56, 1047 1052 doi:10.1093/jac/dki362 Advance Access publication 20 October 2005 Evaluation of PPI-0903M (T91825), a novel cephalosporin: bactericidal activity,
More informationInfections in external ventricular drainage:
Infections in external ventricular drainage: Causes, diagnosis, treatment and prevention Roger Bayston MMedSci MSc PhD FRCPath Professor of Surgical Infection School of Medicine University of Nottingham,
More informationURINARY TRACT INFECTIONS 3 rd Y Med Students. Prof. Dr. Asem Shehabi Faculty of Medicine, University of Jordan
URINARY TRACT INFECTIONS 3 rd Y Med Students Prof. Dr. Asem Shehabi Faculty of Medicine, University of Jordan Urinary Tract Infections-1 Normal urine is sterile in urinary bladder.. It contains fluids,
More informationBacterial peritonitis is a common complication of peritoneal
Peritoneal Dialysis International, Vol. 27, pp. 79 85 Printed in Canada. All rights reserved. 0896-8608/07 $3.00 +.00 Copyright 2007 International Society for Peritoneal Dialysis VANCOMYCIN DISPOSITION
More informationCAUTI CONFERENCE CAUTI Prevention and Appropriate Use of Indwelling Urinary Catheters in the Hospital Setting
CAUTI CONFERENCE CAUTI Prevention and Appropriate Use of Indwelling Urinary Catheters in the Hospital Setting James T. Fields, MD Carolinas Center for Medical Excellence Columbia, South Carolina February
More informationRenal Unit. Catheter Related Bacteraemia Guidelines
Renal Unit Policy Manager Drew Henderson Policy Group Renal Unit Policy Established 21/01/2014 Policy Review Period/Expiry 21/01/2015 Last Updated 21/01/2014 This policy does apply to Medical/Dental Staff
More informationOral Candida biofilm model and Candida Staph interactions
Oral Candida biofilm model and Candida Staph interactions Mark Shirtliff, PhD Associate Professor Department of Microbial Pathogenesis, School of Dentistry Department of Microbiology and Immunology, School
More informationAnatomy kidney ureters bladder urethra upper lower
Urinary tract Anatomy The urinary tract consists of the kidney, ureters, bladder, and urethra. Urinary tract infections can be either: upper or lower based primarily on the anatomic location of the infection.
More informationVenenkatheter-assoziierte Infektionen
Update Infektionen in der Hämatologie und Onkologie Venenkatheter-assoziierte Infektionen Georg Maschmeyer Potsdam www.dghoinfektionen.de Aktuelle Leitlinie der AGIHO...unter Berücksichtigung von: Ann
More informationReinitiation of peritoneal dialysis after catheter removal for refractory peritonitis
J Nephrol (2014) 27:445 449 DOI 10.1007/s40620-014-0048-1 ORIGINAL ARTICLE Reinitiation of peritoneal dialysis after catheter removal for refractory peritonitis R. Ram G. Swarnalatha K. V. Dakshinamurty
More informationIS TIGECYCLINE EFFECTIVE IN CONTINUOUS AMBULATORY PERITONEAL DIALYSIS RELATED PERITONITIS
Acta Medica Mediterranea, 2017, 33: 699 IS TIGECYCLINE EFFECTIVE IN CONTINUOUS AMBULATORY PERITONEAL DIALYSIS RELATED PERITONITIS AYŞE SAĞMAK TARTAR 1, MEHMET ÖZDEN 2, AYHAN DOĞUKAN 3, AYHAN AKBULUT 4,
More informationEnhancement of Infection Control for MRSA in Renal Unit
Enhancement of Infection Control for MRSA in Renal Unit Ms Ida Yip SNO (Infection Control) Hong Kong East Cluster Hospital 19 August 2011 IC Forum (19-8-2011) 1 MRSA Common Multi Drug Resistant Organisms
More informationPRESENTER: DENNIS NYACHAE MOSE KENYATTA UNIVERSITY
18/8/2016 SOURCES OF MICROBIAL CONTAMINANTS IN BIOSAFETY LABORATORIES IN KENYA PRESENTER: DENNIS NYACHAE MOSE KENYATTA UNIVERSITY 1 INTRODUCTION Contamination occurs through avoidable procedural errors
More informationWork-up of Respiratory Specimens Now you can breathe easier
34 th Annual Meeting Southwestern Association of Clinical Microbiology Work-up of Respiratory Specimens Now you can breathe easier Yvette S. McCarter, PhD, D(ABMM) Director, Clinical Microbiology Laboratory
More informationBiofilm and Advanced Wound Management Strategies
Biofilm and Alex Khan APRN ACNS-BC MSN CWCN WCN-C Advanced Practice Nurse Adult Clinical Nurse Specialist Organization of Wound Care Nurses www.woundcarenurses.org 1 Objectives What are Biofilms How Biofilms
More informationBlood cultures in ED. Dr Sebastian Chang MBBS FACEM
Blood cultures in ED Dr Sebastian Chang MBBS FACEM Why do we care about blood cultures? blood cultures are the most direct method for detecting bacteraemia in patients a positive blood culture: 1. can
More information6. Type of peritoneal dialysis catheter
Blackwell Science, LtdOxford, UKNEPNephrology1320-53582004 Asian Pacific Society of NephrologyOctober 20049S3S59S64MiscType of peritoneal dialysis The CARI Guidelines NEPHROLOGY 2004; 9, S59 S64 Date written:
More informationProtective effect of N-acetylcysteine from drug-induced ototoxicity in uraemic patients with CAPD peritonitis
4073 Nephrol Dial Transplant (2011) 26: 4073 4078 doi: 10.1093/ndt/gfr211 Advance Access publication 6 May 2011 Protective effect of N-acetylcysteine from drug-induced ototoxicity in uraemic patients with
More informationProsthetic Joint Infections Review of diagnosis including the role of molecular techniques. Dr Prema Singh
Prosthetic Joint Infections Review of diagnosis including the role of molecular techniques Dr Prema Singh Consultant Microbiologist Watford General Hospital Structure of talk Introduction Case scenario
More informationInnovation in Technology II: Changed and Improved Design. PD Catheters- designs. Bharat Sachdeva MD LSU Shreveport
Innovation in Technology II: Changed and Improved Design PD Catheters- designs Bharat Sachdeva MD LSU Shreveport What s at risk? Why Is Material/Design Important? Reduce risk for transfer to HD Displacement
More informationThe Challenge of Managing Staphylococcus aureus Bacteremia
The Challenge of Managing Staphylococcus aureus Bacteremia M A R G A R E T G R A Y B S P F C S H P C L I N I C A L P R A C T I C E M A N A G E R N O R T H / I D P H A R M A C I S T A L B E R T A H E A
More informationSt George & Sutherland Hospitals PERITONEAL DIALYSIS UNIT RENAL DEPARTMENT Workplace Instruction (Renal_SGH_WPI_097)
PERITONEAL DIALYSIS (PD) PERITONEAL EQUILIBRATION TEST (PET) Cross references NSW Health PD2007_036 - Infection Control Policy SGH-TSH CLIN027 - Aseptic Technique - Competency and Education Requirements
More informationCATHETER-ASSOCIATED URINARY TRACT INFECTIONS
CATHETER-ASSOCIATED URINARY TRACT INFECTIONS Hamid Emadi M.D Associate professor of Infectious diseases Department Tehran university of medical science The most common nosocomial infection The urinary
More information2018 Science Olympiad: Microbe Mission - Sample Tournament Div C
2018 Science Olympiad: Microbe Mission - Sample Tournament Div C Section A: Types of cells and their parts 1. Please state if the cell is prokaryotic or eukaryotic. Then label the following molecular components
More informationUeli von Ah, Dieter Wirz, and A. U. Daniels*
JOURNAL OF CLINICAL MICROBIOLOGY, June 2008, p. 2083 2087 Vol. 46, No. 6 0095-1137/08/$08.00 0 doi:10.1128/jcm.00611-08 Copyright 2008, American Society for Microbiology. All Rights Reserved. Rapid Differentiation
More informationInfected cardiac-implantable electronic devices: diagnosis, and treatment
Infected cardiac-implantable electronic devices: diagnosis, and treatment The incidence of infection following implantation of cardiac implantable electronic devices (CIEDs) is increasing at a faster rate
More informationReviews in Infection
Reviews in Infection RIF 1(1):1-6 (2010) RIF ISSN:1837-6746 Original Research Infection related processes during haemodialysis: A study in General Hospital Haemodialysis unit Naser Hussain 1, *Mona F.
More informationHealthcare-associated infections acquired in intensive care units
SURVEILLANCE REPORT Annual Epidemiological Report for 2015 Healthcare-associated infections acquired in intensive care units Key facts In 2015, 11 788 (8.3%) of patients staying in an intensive care unit
More informationOSTEOMYELITIS. If it occurs in adults, then the axial skeleton is the usual site.
OSTEOMYELITIS Introduction Osteomyelitis is an acute or chronic inflammatory process of the bone and its structures secondary to infection with pyogenic organisms. Pathophysiology Osteomyelitis may be
More informationThe Clinical Significance of Blood Cultures. Presented BY; Cindy Winfrey, MSN, RN, CIC, DON- LTC TM, VA- BC TM
The Clinical Significance of Blood Cultures Presented BY; Cindy Winfrey, MSN, RN, CIC, DON- LTC TM, VA- BC TM OVERVIEW Blood cultures are considered an important laboratory tool used to diagnose serious
More informationBlood Culture Collection and Interpretation
Blood Culture Collection and Interpretation Catherine Ernst, RN,PBT(ASCP) Blood Cultures Indications for blood culture collection Proper method for blood culture collection Interpreting a blood culture
More informationGetting the Point of Injection Safety
Getting the Point of Injection Safety Barbara Montana, MD, MPH, FACP Medical Director Communicable Disease Service Outbreak of Enterococcus faecalis endocarditis associated with an oral surgery practice
More informationStaphylococci. What s to be Covered. Clinical Scenario #1
Staphylococci Micrococcus, which, when limited in its extent and activity, causes acute suppurative inflammation (phlegmon), produces, when more extensive and intense in its action on the human system,
More informationInternational Journal of Medical Science and Education pissn eissn
CATHETER ASSOCIATED URINARY TRACT INFECTION (CAUTI) INDUCED NOSOCOMIAL INFECTION WITH REFERENCE TO INCIDENCE, DURATION AND ORGANISM IN A TERTIARY CARE TEACHING HOSPITAL Dr.Trilok Patil* Associate Professor,
More informationWhat s to be Covered. Microbiology of staphylococci Epidemiology of S. aureus infections Pathogenesis of S. aureus infections
Staphylococci Micrococcus, which, when limited in its extent and activity, causes acute suppurative inflammation (phlegmon), produces, when more extensive and intense in its action on the human system,
More information2018 CNISP HAI Surveillance Case definitions
2018 CNISP HAI Surveillance Case definitions The following case definitions for the surveillance of healthcare-associated infections (HAIs) are used by all acute-care hospitals that participate in the
More informationInfections Amenable to OPAT. (Nabin Shrestha + Ajay Mathur)
3 Infections Amenable to OPAT (Nabin Shrestha + Ajay Mathur) Decisions regarding outpatient treatment of infections vary with the institution, the prescribing physician, the individual patient s condition
More informationLeukopenic and Lethal Effects of Slime from Acinetobacter calcoaceticus
Leukopenic and Lethal Effects of Slime from Acinetobacter calcoaceticus Yoshiki OBANA and Takeshi NISHINO Department of Microbiology, Kyoto Pharmaceutical University Key words: A.calcoaceticus, slime,
More informationUTI are the most common genitourinary disease of childhood. The prevalence of UTI at all ages is girls and 1% of boys.
UTI are the most common genitourinary disease of childhood. The prevalence of UTI at all ages is girls and 1% of boys. 1-3% of Below 1 yr. male: female ratio is 4:1 especially among uncircumcised males,
More informationPeritoneal nitric oxide is a marker of peritonitis in patients on continuous ambulatory peritoneal dialysis
Nephrol Dial Transplant (1996) 11: 2466-2471 Original Article Nephrology Dialysis Transplantation Peritoneal nitric oxide is a marker of peritonitis in patients on continuous ambulatory peritoneal dialysis
More informationNuclear medicine and Prosthetic Joint Infections
Nuclear medicine and Prosthetic Joint Infections Christophe Van de Wiele, M.D., Ph.D. Department of Nuclear Medicine, University Hospital Ghent, Belgium Orthopedic prostheses: world market 1996 Prosthetic
More informationEDUCATIONAL COMMENTARY THROAT CULTURES LEARNING OUTCOMES. Upon completion of this exercise, the participant should be able to:
EDUCATIONAL COMMENTARY THROAT CULTURES LEARNING OUTCOMES Upon completion of this exercise, the participant should be able to: distinguish three types of hemolysis produced by bacterial colonies. discuss
More informationDecember 3, 2015 Severe Sepsis and Septic Shock Antibiotic Guide
Severe Sepsis and Septic Shock Antibiotic Guide Surviving Sepsis: The choice of empirical antimicrobial therapy depends on complex issues related to the patient s history, including drug intolerances,
More informationComparison of Meropenem with Ceftazidime as Monotherapy of Cancer Patients with Chemotherapy induced Febrile Neutropenia
Comparison of Meropenem with Ceftazidime as Monotherapy of Cancer Patients with Chemotherapy induced Febrile Neutropenia I. Malik ( National Cancer lnsititute, Karachi ) Shaharyar (, Department of Radiotherapy
More informationContact Time for Foods of Different Textures Leads to Differential Bacterial Growth: Testing the Five Second Rule
International Journal of Applied Environmental Sciences ISSN 0973-6077 Volume 11, Number 6 (2016), pp. 1387-1396 Research India Publications http://www.ripublication.com Contact Time for Foods of Different
More informationUsefulness of Peritoneal Fluid Amylase Levels in the Differential Diagnosis of Peritonitis in Peritoneal Dialysis Patients
Usefulness of Peritoneal Fluid Levels in the Differential Diagnosis of Peritonitis in Peritoneal Dialysis Patients John Burkart, M.D.,2 Steve Haigler, M.D., Ralph Caruana, M.D., and Britta Hylander, M.D.
More informationBiofilms: Álvaro Pascual MD, PhD Department of Microbiology
Biofilms: Role on Pathogenesis and Treatment of UTIs. Álvaro Pascual MD, PhD Department of Microbiology University of Seville. Spain. Medical devices-related infections 1. 35 millions/year in USA 2. Most
More information