Abstract:Antimicrobial treatment is often indicated to neutropenic patients. Although renal failure is a common complication of many antibiotics, no information could be found in the literature defining which are the best screening criteria for detecting renal injury. In this paper, the authors aim to assess the progress to renal failure in neutropenic patients on antimicrobial use and to compare different diagnostic criteria of renal failure in association to antimicrobial agents used. This is a cohort study conducted… Show more
“…Most common pathogens include Escherichia coli, Klebsiella, Proteus, more rarely Campylobacter, Citrobacter, Acinetobacter etc. Initial empiric antimicrobial treatment of peritonitis (cephalosporins, vancomycin, aminoglycosides) revealed no clinical improvement, since the isolated Acinetobacter organism was resistant to all tested antibiotics, except colistin 8,15 . Immunocompromised patients are particularly susceptible.…”
Introduction.Immunocompromised patients, such as those with multiple myeloma on peritoneal dialysis, are particularly susceptible to the occurrence of peritonitis. Case report. We presented a 56-year-old female patient with a 10-year history of multiple myeloma. The patient was on peritoneal dialysis since 2010. During 2012 the patient had the first episode of peritonitis that was successfully managed, but in 2013 the second episode of peritonitis occured. Analysis of dialysate culture and exit site swab revealed the presence of multiresistant Acinetobacter spp., which was susceptible only to colistin. Prompt colistin therapy was administered at the doses of 100,000 units/day during six days, which resulted in complete recovery of the patient, as well as improvement of local abdominal findings. Gram-negative bacteria (genus Acinetobacter) are common causative agents in hospital-acquired infections. Studies confirmed susceptibility of Acinetobacter to colistin, which was also the case with the presented patient. Intravenous administration of colistin resulted in a complete remission of this severe, life-threatening peritonitis. Conclusion. Patients with multiple myeloma and renal failure are highly prone to severe life-threatening infections.Uvod. Imunokompromitovani bolesnici, kao što su bolesnici sa multiplim mijelomom na peritoneumskoj dijalizi, posebno su skoloni nastanku peritonitisa. Prikaz bolesnika. Prikazali smo bolesnicu, staru 56 godina, koja je bolovala od multiplog mijeloma 10 godina. Od 2010. god. lečila se metodom peritoneumske dijalize. Prvu epizodu peritonitisa koja je uspešno sanirana, imala je tokom 2012. U 2013. ponovo je došlo do razvoja peritonitisa. Analizom kulture dijalizata i brisom izlaznog mesta peritoneumskog katetera izolovan je multirezistentni Acinetrobacter spp, osetljiv samo na kolistin. Primenom kolistina u dozi od 100 000 jedinica/dan tokom šest dana došlo je do potpunog poboljšanja opšteg stanja bolesnice, kao i lokalnog nalaza na trbuhu. Gramnegativna bakterija (Acinetobacter spp) čest je uzročnik hospitalnih infekcija. Istraživanja potvrđuju osetljivost Acinetobacter spp. na kolistin, što je slučaj kod prikazane bolesnice. Intravenska primena kolistina rezultovala je potpunim oporavkom od teškog, po život opasnog, peritonitisa. Zaključak. Bolesnici sa multiplim mijelomom i bubrežnom insuficijencijom imaju povećanu sklonost ka nastanku teških, po život opasnih, infekcija.
“…Most common pathogens include Escherichia coli, Klebsiella, Proteus, more rarely Campylobacter, Citrobacter, Acinetobacter etc. Initial empiric antimicrobial treatment of peritonitis (cephalosporins, vancomycin, aminoglycosides) revealed no clinical improvement, since the isolated Acinetobacter organism was resistant to all tested antibiotics, except colistin 8,15 . Immunocompromised patients are particularly susceptible.…”
Introduction.Immunocompromised patients, such as those with multiple myeloma on peritoneal dialysis, are particularly susceptible to the occurrence of peritonitis. Case report. We presented a 56-year-old female patient with a 10-year history of multiple myeloma. The patient was on peritoneal dialysis since 2010. During 2012 the patient had the first episode of peritonitis that was successfully managed, but in 2013 the second episode of peritonitis occured. Analysis of dialysate culture and exit site swab revealed the presence of multiresistant Acinetobacter spp., which was susceptible only to colistin. Prompt colistin therapy was administered at the doses of 100,000 units/day during six days, which resulted in complete recovery of the patient, as well as improvement of local abdominal findings. Gram-negative bacteria (genus Acinetobacter) are common causative agents in hospital-acquired infections. Studies confirmed susceptibility of Acinetobacter to colistin, which was also the case with the presented patient. Intravenous administration of colistin resulted in a complete remission of this severe, life-threatening peritonitis. Conclusion. Patients with multiple myeloma and renal failure are highly prone to severe life-threatening infections.Uvod. Imunokompromitovani bolesnici, kao što su bolesnici sa multiplim mijelomom na peritoneumskoj dijalizi, posebno su skoloni nastanku peritonitisa. Prikaz bolesnika. Prikazali smo bolesnicu, staru 56 godina, koja je bolovala od multiplog mijeloma 10 godina. Od 2010. god. lečila se metodom peritoneumske dijalize. Prvu epizodu peritonitisa koja je uspešno sanirana, imala je tokom 2012. U 2013. ponovo je došlo do razvoja peritonitisa. Analizom kulture dijalizata i brisom izlaznog mesta peritoneumskog katetera izolovan je multirezistentni Acinetrobacter spp, osetljiv samo na kolistin. Primenom kolistina u dozi od 100 000 jedinica/dan tokom šest dana došlo je do potpunog poboljšanja opšteg stanja bolesnice, kao i lokalnog nalaza na trbuhu. Gramnegativna bakterija (Acinetobacter spp) čest je uzročnik hospitalnih infekcija. Istraživanja potvrđuju osetljivost Acinetobacter spp. na kolistin, što je slučaj kod prikazane bolesnice. Intravenska primena kolistina rezultovala je potpunim oporavkom od teškog, po život opasnog, peritonitisa. Zaključak. Bolesnici sa multiplim mijelomom i bubrežnom insuficijencijom imaju povećanu sklonost ka nastanku teških, po život opasnih, infekcija.
“…One of the most fearful side effects of antibiotics is nephrotoxicity, such as AKI or CKD. It is estimated that acute renal failure is associated with mortality rates exceeding 50% in critically ill patients [ 4 ]. Streptococcal toxic shock syndrome is another severe complication factor that is strongly associated with mortality [ 16 ].…”
Section: Discussionmentioning
confidence: 99%
“…Nephrotoxins are present in aminoglycosides and antibiotics such as vancomycin. Therefore, the use of antibiotics in patients with renal failure is limited since it can cause complications such as acute kidney injury (AKI) or chronic kidney disease (CKD) [ 4 ]. Occurrence of NF in patients with thoracic aortic aneurysms is normally very rare but is quite common in elderly patients.…”
Necrotizing fasciitis (NF) is defined as rapidly progressive necrosis of subcutaneous fat and fascia. Although NF of the face is rare, its mortality rate is nearly 30%. It usually originates from dental infection and can lead to involvement of the neck, mediastinum, and chest wall. Complications resulting from pre-existing systemic diseases can increase the mortality rate. Known complication factors for NF include diabetes, malnutrition, advanced age, peripheral vascular disease, renal failure, and obesity. Here, we report a case of NF originating from dental infection in an 88-year-old woman already diagnosed with hypertension, thoracic aortic aneurysm, and renal diseases. Such conditions limited adequate surgical and antibiotic treatment. However, interdisciplinary treatment involving multiple departments was implemented with good results.
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