Category Archives: Infections
Bloodstream Infection Rates in Outpatient Hemodialysis Facilities Participating in a Collaborative Prevention Effort: A Quality Improvement Report
Dr. Priti R. Patel, MD, MPH
Division of Healthcare Quality Promotion
National Center for Emerging and Zoonotic Infectious Diseases
Centers for Disease Control and Prevention, Atlanta, GA
Hemodialysis.com: What are the main findings of the study?
Dr. Patel: In 2009, the Centers for Disease Control and Prevention (CDC) partnered with a group of outpatient dialysis centers on a collaborative initiative to prevent bloodstream infections (BSIs) in hemodialysis patients. Seventeen outpatient hemodialysis facilities worked together to implement a set of CDC-recommended interventions for BSI prevention. Rates of BSI and access-related BSI reported to CDC’s National Healthcare Safety Network (NHSN) were examined from January 2009 through March 2011. By implementing the interventions in a systematic manner, the facilities participating in this initiative were able to reduce their rate of overall BSI by 32% and rate of access-related BSI by 54%.
The interventions used included chlorhexidine antiseptic for catheter exit-site care, staff training and competency assessments focused on catheter care and aseptic technique, hand hygiene and vascular access care audits, and feedback of infection and adherence rates to staff. Facility staff were also encouraged to use antimicrobial ointment on catheter exit sites. For a complete list of the BSI prevention steps recommended by CDC, please see http://www.cdc.gov/dialysis/prevention-tools/core-interventions.html.
Marie Benz, MD on Google+Seroprevalence of Streptococcal Inhibitor of Complement (SIC) suggests association of streptococcal infection with chronic kidney disease
Hemodialysis.com eInterview with:
Dr.M.G.Karmarkar
Professor of Microbiology
Seth G.S Medical College
& K.E.M Hospital,
Parel, Mumbai – 40
Hemodialysis.com: What are the main findings of the study?
Dr. Karmarkar: Past infection with SIC positive GAS is a risk factor for development of CKD and ESRD in Mumbai Population. SIC seropositivity is predictive of POOR prognosis of CKD patients. emm typing of GAS strains isolated from School children during project period showed great diversity as reported in other parts of the country. Although in two of our recent studies, very few isolates have genetic capability to produce SIC and DRS. As compared to healthy controls, seropositivity to SIC was found to be significantly elevated in CKD and ESRD cohort’s .Also, Prevalence of SIC seropositivity is independent of age, sex and diabetes status in the study sample of people with renal disease.
Persistent nasal methicillin-resistant staphylococcus aureus carriage in hemodialysis outpatients: a predictor of worse outcome.
Hemodialysis.com eInterview with: Holger Schmid MD, MSc
KfH Nierenzentrum Muenchen-Laim,
Department of Internal Medicine
University Hospital Munich
University of Munich, Munich, Germany
Hemodialysis.com: What are the main findings of the study?
Dr. Schmid: In ambulatory patients receiving long-term hemodialysis (HD) persistent
nasal MRSA carriage with failure of Mupirocin decolonization was
associated with an extremely poor prognosis and an increased all-cause
mortality rate.
A history of malignancy and an increased Charlson Index were significant predictors for nasal MRSA carriers.
Concomitant extra-nasal MRSA colonization in nasal MRSA carriers had no influence on nasal decolonization failure or outcome.
Impact of non-dialysis chronic kidney disease on survival in patients with septic shock
Hemodialysis.com Author Interview: Julien Maizel, MD
Medical Intensive Care Unit, Department of Nephrology,
Amiens University Medical Center
Amiens, France and INSERM U-1088, Jules Verne University of Picardie
Amiens, France
Hemodialysis.com: What are the main findings of the study?
Answer: The key finding from this retrospective study is that CKD (not on dialysis) is an independent factor of mortality after septic shock.
Antimicrobial Use in Outpatient Hemodialysis Units
Hemodialysis.com Interview with: Dr. Graham Snyder
Beth Israel Deaconess Medical Center
110 Francis St
Boston, MA 02215
Hemodialysis.com: What are the main findings of the study?
Dr. Snyder: We looked at antimicrobial use in two Boston-area hemodialysis units in two ways: over a nearly three-year retrospective time period, we calculated the total amount of antimicrobials used, and prospectively over a one-year time period we analyzed each dose of parenteral antimicrobial administered in the hemodialysis units.
CMV seropositivity is associated with increased arterial stiffness in patients with CKD
Hemodialysis.com Author Interview:
Charlie J. Ferro, BSc, MD, FRCP
School of Immunity and Infection, University of Birmingham
Birmingham, United Kingdom
Hemodialysis.com:What are the main findings of the study?
Dr. Ferro: Patients with chronic kidney disease have an increased cardiovascular risk that is not fully explained by traditional risk factors but appears to be related to increased arterial stiffness. Cytomegalovirus (CMV) infection is associated with increased cardiovascular risk although the mechanisms for this are unknown. In our study, arterial stiffness, as measured by carotid-femoral pulse wave velocity and arterial aortic distensibilty, was consistently and considerably higher in CMV seropositive patients.
Infection Rates and Associated Pathogens in Patients on Nocturnal Home Hemodialysis Over a Six Year Period
Hemodialysis.com Author Interview: Marisa Battistella, BSc Phm, Pharm D, ACPR
Pharmacy Clinician Scientist
Assistant Professor
Leslie Dan Faculty of Pharmacy, University of Toronto
Clinical Pharmacist-Nephrology
University Health Network
Hemodialysis.com: What are the main findings of the study?
Dr. Battistella: Our study consisted of a 6 year retrospective analysis of the 90 NHD patients.
We evaluated the culture and sensitivity of all samples drawn in NHD patient, prescribed antibiotics and clinical demographic data such as age, gender, race, primary renal disease, comorbidities and duration of dialysis.
