management and molecular analysis of candidaemia related to a totally implantable vascular access in a cystic fibrosis patient

Bonacorsi, Stéphane; Munck, À.; Gérardin, M.; Brahimi, N.; Navarro, J; Bingen, Édouard

doi:10.1016/s0163-4453(96)92795-4

Cited by 7 publications

(3 citation statements)

References 10 publications

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“…SOLA et al [7] and DEEROJANAWONG et al [11] identified certain factors potentially increasing the infection rate, including corticosteroid therapy, parenteral nutrition, diabetes mellitus, malnutrition, severe respiratory deficiency, and frequent broad-spectrum antibiotic therapy. A high incidence of fungal septicaemia (66% in this study) occurs among CF patients [17,18]. Whether or not CF patients with TIVADs should receive daily antifungal prophylaxis is controversial [8,18,19].…”

Section: Discussionmentioning

confidence: 72%

Follow-up of 452 totally implantable vascular devices in cystic fibrosis patients

Munck

Malbezin²,

Bloch³

et al. 2004

Eur Respir J

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The use and complications of totally implantable vascular access devices (TIVADs) were examined during multiple courses of antibiotics in cystic fibrosis (CF) patients.This retrospective study involved 36 CF centres. Risk factors for removal and septicaemia were sought by survival analysis of censored data. Multivariate Cox models were constructed with removal or septicaemia as the event and the characteristics of TIVADs as explanatory variables.TIVADs (n=452) were implanted in 315 patients. The mean functional time per device was 32¡25 months. Long-term complications occurred with 188 devices (42%); they consisted mainly of occlusion (21%, requiring removal in 77%), infection (9.3%, requiring removal in 85%; septicaemia in 7.3%; rate 0.3 per 1,000 days, Candida in 66%), and vascular thrombosis (4.7%, removal in 58%). Multivariate survival analysis showed that removal, whatever the reason, was associated with polyurethane (versus silicone) and routine use of the device for blood sampling (versus never). No risk factors, including heparin lock, were identified for septicaemia or for removal for obstruction.Totally implantable venous access devices appear to be safe and reliable for longterm intermittent venous access. Although retrospective, this study suggests that the characteristics of the material and blood sampling are risk factors for removal. Chronic infections in patients with cystic fibrosis (CF), especially after colonisation by Pseudomonas aeruginosa, require repeated courses of intravenous antibiotics. Increasing problems with peripheral venous access may indicate implantation of a central venous access.Relative to external central catheters, totally implantable vascular access devices (TIVADs) facilitate long-term maintenance, permit almost unlimited physical activity, and improve the patient9s self-image, which is especially important for children and young adults. Nevertheless, TIVADs are associated with a number of complications. Previous studies of these devices in CF patients have involved small groups. The experience of 36 CF centres over a period of 9 yrs is reported here, based on systematic review of the implantation procedure, use, long-term maintenance and complications. Materials and methods PatientsThe medical charts of 315 CF patients who underwent one or more TIVAD procedures between January 1990 and December 1998 were reviewed. The patients were treated in 36 CF centres. A chart was sent to a corresponding physician in each CF centre who collected the data for all the patients treated in their centre. Data analysed included patient age, P. aeruginosa colonisation, surgical reports (TIVAD model, insertion site, procedure, prophylactic antibiotics, immediate complications), TIVAD use (courses of antibiotics, parenteral nutrition, lipid infusion, blood sampling), long-term maintenance (heparin, physiological sera, counter-pressure), longterm complications (catheter occlusion, vascular thrombosis, infection, discomfort, catheter rupture, displacement or disconnection, aestheti...

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Section: Discussionmentioning

confidence: 72%

Follow-up of 452 totally implantable vascular devices in cystic fibrosis patients

Munck

Malbezin²,

Bloch³

et al. 2004

Eur Respir J

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“…The RAPD method of DNA fingerprinting has become quite popular for all infectious fungi and has been successfully applied to C. albicans (see, e.g., references 22,36,37,77,83,86,131,140,141,181,223,288,306,309,369, and 393), C. dubliniensis (79), C. parapsilosis (199), C. lusitaniae (163,181), C. tropicalis (181,187), C. glabrata (195,181,337,387), C. krusei (437), C. famata (437), C. rugosa, (437), A. fumigatus (5,11,178,187,200,202,228,296), A. flavus (51), Cryptococcus neoformans (32,33,41,68,71,72,117,197,282,311,…”

Section: Random Amplified Polymorphic Dna and Related Pcr-based Fingementioning

confidence: 99%

The Ins and Outs of DNA Fingerprinting the Infectious Fungi

Soll

2000

Clinical Microbiology Reviews

282

317

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“…O método RAPD tem demonstrado grande êxito em estudos sobre infecções fúngicas, especialmente para C. albicans (123,124,125,126,127,128,129,130,12,13,132,133). Apesar da técnica apresentar rapidez, simplicidade e alto poder discriminatório, várias limitações sobre seus procedimentos foram apontadas.…”

Section: Introductionunclassified

Ferramentas Moleculares Para Caracterização De Candida Albicans (Robin) Berkhout (1923) Em Estudos Epidemiológicos

Boriollo¹,

Höfling

Mendes

et al. 2005

Estud Biol.

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Essa revisão busca apresentar uma descrição dos principais recursos moleculares empregados em estudos epidemioló gicos envolvendo candidoses. São abordados os recursos mais comumente empregados em Epidemiologia Molecular e baseados em polimorfismos proté icos (Eletroforese de Isoenzimas) e de á cidos nuclé icos (Eletrocariotipagem, Polimorfismo dos Fragmentos de Restrição, e Polimorfismos do DNA Amplificado ao Acaso). São apresentadas as características de cada mé todo, bem como suas vantagens e desvantagens.

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management and molecular analysis of candidaemia related to a totally implantable vascular access in a cystic fibrosis patient

Cited by 7 publications

References 10 publications

Follow-up of 452 totally implantable vascular devices in cystic fibrosis patients

Follow-up of 452 totally implantable vascular devices in cystic fibrosis patients

The Ins and Outs of DNA Fingerprinting the Infectious Fungi

Ferramentas Moleculares Para Caracterização De Candida Albicans (Robin) Berkhout (1923) Em Estudos Epidemiológicos

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