Ralstonia pickettii sepsis in a hemodialysis patient from Bulgaria

Kostyanev, Tomislav; Setchanova, Lena

doi:10.1016/j.bjid.2012.06.010

Cited by 21 publications

(15 citation statements)

References 8 publications

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“…The use of filters with a high permeability and good biocompatibility, transfusion of a large amount of displacement liquid, and equipment with a highly accurate fluid balance system provide this methodology with the following advantages: stable hemodynamics, continuous and stable control of azotemia and the water-electrolyte metabolism, continuous elimination of toxins and intermediate molecular weight substances in the blood stream, provision of nutritional supplements and drug treatment on demand, and achievement of a stable balance in critical patients (Saxena et al, 2012;Strateva et al, 2012). CBP can be used in patients with low blood pressure and can also create nutrition support.…”

Section: Discussionmentioning

confidence: 99%

Disease indicators for sepsis and analysis of sepsis treatment in children using the continuous blood purification technique

2015

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Section: Discussionmentioning

confidence: 99%

Disease indicators for sepsis and analysis of sepsis treatment in children using the continuous blood purification technique

2015

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“…3 patients from same HD center; none of the patient was admitted Strateva et al 13 1 patient with permanent vascular catheter was treated with intravenous ceftriaxone after being febrile for a few days. Blood and dialysis fluid culture grew R. pickettii.…”

Section: Case Reportmentioning

confidence: 99%

“…Nosocomial infections among susceptible individuals are more frequently reported and there has been a few documented outbreaks in the literature, particularly relating to contamination of pharmaceutical solutions and in varied settings including oncology outpatients, pediatric emergency department, hematology inpatient ward, and neonatal intensive care unit . Reports of outbreaks came from diverse countries including Taiwan, China, Italy, India, Bulgaria, Germany, and United States . Due to its heighten profile, soaring prevalence, evolving resistance, and virugenic potential, early reporting and identification of infections are necessary to curtail the serious challenges pose by the bacteria in the future.…”

Section: Introductionmentioning

confidence: 99%

Outbreak of nonfermentative Gram‐negative bacteria (Ralstonia pickettii and Stenotrophomonas maltophilia) in a hemodialysis center

Thet

Pelobello

Das

et al. 2019

Hemodialysis International

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We report a case series of seven patients with nonfermentative Gram‐negative bacteria infections in a single dialysis center; four patients with Ralstonia pickettii and three patients with Stenotrophomonas maltophilia. Two of the seven patients were admitted to hospital for intravenous antibiotic treatment, while the rest were treated with oral antibiotics at home. Both the admitted patients had temporary vascular catheter infections from the aforementioned pathogens. We conclude that the outbreak is due to colonization of treated reverse osmosis water, presumably through contamination via polluted filters and compounded by the usage of reprocessed dialysers in the dialysis center. This is especially relevant because contaminated treated water is directly introduced into the blood compartment of the dialysers during reprocessing. In addition, there seems to be a propensity for both organisms to cause prolonged febrile reactions in patients with temporary vascular catheters, likely through the early development of biofilm. Intensification of general sterilization procedures, servicing and replacement of old decrepit components of the water treatment system and temporary cessation of dialyser reuse practice seem to have halted the outbreak. Due to the virulent nature and difficult resistant profile of nonfermentative Gram‐negative bacteria, we strongly recommend meticulous vigilance in the surveillance of culture isolates in routine microbiological specimens from dialysis centers, especially if there is a senescent water treatment system and a practice of reprocessing dialysers.

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“…Also, S. maltophilia was shown to induce bacteremia in a dialysis patient with long-term central venous catheter (Kara, YilmazM, Şit, Kadiroğlu, & Kökoğlu, 2006) and in end-stage renal disease patients receiving maintenance hemodialysis (Gnanasekaran & Bajaj, 2009). Strateva, Kostyanev, and Setchanova (2012) reported a case of sepsis induced by R. pickettii in a hemodialysis patient from Bulgaria. Kaitwatcharachai, Silpapojakul, SirojJitsurong, & Kalnauwakul (2000) reported a subclavian catheter-related B. cepacia outbreak in nine patients undergoing hemodialysis; authors also observed that B. cepacia formed biofilms while growing in the catheters.…”

Section: Biochemical Identification Of Isolated Bacteriamentioning

confidence: 99%

<b>Detection of microorganisms, endotoxins and aluminum in mobile dialysis services

Jesus

Ferreira

Freitas

et al. 2017

Acta Sci. Biol. Sci.

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ABSTRACT. Hemodialysis water and dialysates are fundamental in the treatment of kidney disease. During just one hemodialysis session, 120 liters of dialysate are consumed. Thus, it is essential that the parameters of chemical and microbiological quality of the fluids used in dialysis systems are carefully observed. In this study, water samples were collected at 12 hospitals in the state of Rio de Janeiro. The samples were obtained at three points of fluid reservoirs: pre-, post-osmosis and dialysis solution. After collection, colony forming units (CFU), total coliforms and Escherichia coli 100 mL -1 were quantified. Later, isolated colonies and endotoxin content were identified by biochemical assays. Data about total aluminum levels per sample (mg L -1 ) were also obtained. Samples of all mobile dialysis services and points of collection were contaminated above the levels set out by national laws, in particular by Pseudomonas aeruginosa. Endotoxin levels were also above the recommended by current legislation (> 0.25 EU mL -1 ). Only three samples contained detectable levels of aluminum, which were found to be above the recommended values for the corresponding resolution (0.01 mg L -1 ). Finally, there were no observable amounts of total coliforms and E. coli 100 mL -1 sample. The data from this study are an important step forward in the standardization and control of chemical/microbiological quality of mobile dialysis services.Keywords: dialysis, hemodialysis units, dialysis solutions.Detecção de microrganismos, endotoxinas e alumínio em serviços de diálise móvel RESUMO. Águas de hemodiálise e dialisatos são peças fundamentais na terapêutica da doença renal. Durante apenas uma sessão de hemodiálise, são consumidos aproximadamente 120 litros de dialisato. Desta forma, é essencial que os parâmetros de qualidade microbiológica e química dos fluidos utilizados em sistemas de diálise sejam cuidadosamente observados. Neste trabalho, foram coletadas amostras de água em 12 hospitais do Estado do Rio de Janeiro. Amostras foram obtidas em pontos pré-osmose, pós-osmose e solução de diálise. Após coleção, quantificaram-se unidades formadoras de colônias (UFC), coliformes totais e Escherichia coli 100 mL ). Por fim, não foram encontradas quantidades observáveis de coliformes totais e E. coli 100 mL -1 de amostra. Dados de nosso estudo são importante avanço na padronização e controle de qualidade química/microbiológica em serviços de diálise móvel.Palavras-chave: diálise, unidades hospitalares de hemodiálise, soluções para diálise.

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Ralstonia pickettii sepsis in a hemodialysis patient from Bulgaria

Cited by 21 publications

References 8 publications

Disease indicators for sepsis and analysis of sepsis treatment in children using the continuous blood purification technique

Disease indicators for sepsis and analysis of sepsis treatment in children using the continuous blood purification technique

Outbreak of nonfermentative Gram‐negative bacteria (Ralstonia pickettii and Stenotrophomonas maltophilia) in a hemodialysis center

<b>Detection of microorganisms, endotoxins and aluminum in mobile dialysis services

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