Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2010
Cause and outcome of central venous catheter infections in paediatric haemodialysis patients.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Silverstein Douglas M, Moylan Kathleen
Аннотация
BACKGROUND: Paediatric patients with end-stage renal disease often receive haemodialysis (HD) via a central venous catheter (CVC). The most common problem with CVC is infection.
METHODS: We assessed infection rates and subsequent outcome in paediatric chronic HD patients receiving dialysis via a CVC.
RESULTS: Over a 3-year period, there were 28 episodes of infection in 17 patients. The overall rate of infection was 13.7 infections/100 catheter months. Among all catheters, catheter survival was 4.5 ± 0.8 months and similar in infected versus uninfected catheters. Among the 28 infections, there were 43 organisms captured. The most common organisms were Gram-positive, comprising 79% of all species. Among Gram-positive organisms, all coagulase-negative and -positive organisms were sensitive to vancomycin while all enterococci were sensitive to vancomycin. The majority of Gram-negative organisms were sensitive to aminoglycosides or cephalosporins. Among infected catheters, the rate of thrombosis was 1 event/1.7 catheter months; in uninfected catheters, the overall prevalence and rate of thrombosis was similar (1 event/1.6 catheter months). Thirty-nine percent of infections resulted in catheter loss within the subsequent 2 months, the most common reason being catheter occlusion. Multiple organisms/episode were more common in patients who required catheter replacement (46%) than in those who had salvage of the catheter (25%).
CONCLUSIONS: In summary, HD catheter infection rates are high, while thrombosis rates are similar in infected and uninfected catheters. Infection with Gram-positive organisms was most common. The vast majority of CVC infections are cleared by antibiotics, although catheter loss is not uncommon even after clearance of the organism.
METHODS: We assessed infection rates and subsequent outcome in paediatric chronic HD patients receiving dialysis via a CVC.
RESULTS: Over a 3-year period, there were 28 episodes of infection in 17 patients. The overall rate of infection was 13.7 infections/100 catheter months. Among all catheters, catheter survival was 4.5 ± 0.8 months and similar in infected versus uninfected catheters. Among the 28 infections, there were 43 organisms captured. The most common organisms were Gram-positive, comprising 79% of all species. Among Gram-positive organisms, all coagulase-negative and -positive organisms were sensitive to vancomycin while all enterococci were sensitive to vancomycin. The majority of Gram-negative organisms were sensitive to aminoglycosides or cephalosporins. Among infected catheters, the rate of thrombosis was 1 event/1.7 catheter months; in uninfected catheters, the overall prevalence and rate of thrombosis was similar (1 event/1.6 catheter months). Thirty-nine percent of infections resulted in catheter loss within the subsequent 2 months, the most common reason being catheter occlusion. Multiple organisms/episode were more common in patients who required catheter replacement (46%) than in those who had salvage of the catheter (25%).
CONCLUSIONS: In summary, HD catheter infection rates are high, while thrombosis rates are similar in infected and uninfected catheters. Infection with Gram-positive organisms was most common. The vast majority of CVC infections are cleared by antibiotics, although catheter loss is not uncommon even after clearance of the organism.