Incidence of pyrexia in patients undergoing haemodialysis (original) (raw)
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Journal of the American Society of Nephrology, 1992
High-efficiency (HE) and high-flux (HF) hemodialysis are becoming increasingly popular methods for treating patients with chronic renal failure because they reduce the time required for dialysis treatment. HF and HE dialyzers require bicarbonate dialysate, often prepared from concentrates that can support bacterial growth with endotoxin production. There is a concern that endotoxins or bacteria may cross or interact at the membranes of these dialyzers, triggering the release of endogenous pyrogens (cytokines) by peripheral blood mononuclear cells to cause pyrogenic reactions (PR). To determine the incidence of PR and to examine the association between PR and levels of bacteria and endotoxin in dialysate, a cohort of patients receiving conventional, HE, or HF hemodialysis with bicarbonate dialysate and reprocessed dialyzers at three dialysis centers during a 12-month period was studied prospectively. All dialyzers underwent a test of membrane integrity before use. A total of 19 PR we...
Microbiological quality of water and dialysate in all haemodialysis centres of Greece
Nephrology Dialysis Transplantation, 1998
filters, but mean values of all the examined microorganisms were not statistically different from those of Background. Bacterial contamination of treated water and dialysate comprises an important problem for the other centres. Faecal streptococci counts in treated water samples were positively correlated with ageing patients undergoing haemodialysis. Both the progressive reduction of the thickness of cellulose membranes of both haemodialysis centres (P<0.005) and purification system (P<0.05), whereas pseudomonas counts and the expanding use of high-flux membranes probably enhance the risk of pyrogenic reactions, therefore were significantly correlated with ageing of the purification system (P<0.05). increasing the need for atoxic water and non-pyrogenic dialysis fluid.
Infections in hemodialysis: a concise review - Part 1: bacteremia and respiratory infections
Hippokratia, 2011
Hemodialysis (HD) patients are particularly predisposed to infections. It seems that the HD procedure per se as well as disturbances in both innate and adaptive immunity significantly contribute to this susceptibility. Infections are the major cause of morbidity and the second cause of death following cardiovascular events in HD patients. Episodes of bacteremia and pneumonia account for the majority of severe infections in this population. In addition to these bacterial infections another common problem in HD units is the blood transmitted viral infections, particularly infections caused by hepatitis B virus, hepatitis C virus and Human immunodeficiency virus. A number of safety concerns exist for limiting the spread of these viral infections among HD patients and the staff of the unit. The aim of the present review is to present in a concise albeit practical form the difficult aspect of infections in HD. For practical reasons the review is separated in two parts. The present first ...
University Journal of Pre and Paraclinical Sciences, 2016
INTRODUCTION Fever could have many causes including infective and non infective origin. PUO is a clinical syndrome that may result from much common aetiology which was characterized by prolonged fever without the signs or symptoms indicative of a well defined disease process. AIMS OBJECTIVES To find the infectious causes of fever by microscopy, serology and culture methods, To compare quantitative buffy coat vs peripheral smear study for the detection of malarial parasite and To find out Antimicrobial Susceptibility pattern of the organisms isolated. MATERIALS METHODS Patients with undiagnosed fever for more than three weeks duration were included in this study. Respective Specimens (blood, urine, pus, CSF, sputum, throat swab) were collected aseptically and processed according to standard laboratory procedures. RESULTS Among the 125 patients selected 66 were males and 59 were females. The causes of Pyrexia of unknown origin were Infectious in 62.4, Collagen disorder in 3.2, Neoplas...
Comparison of microbiologic assay methods for hemodialysis fluids
Journal of clinical microbiology, 1991
To help prevent pyrogenic reactions and bacteremia in hemodialysis patients, the Association for the Advancement of Medical Instrumentation and the Centers for Disease Control recommend microbiologic assay of hemodialysis fluids at least monthly. Five commercially available assay systems were evaluated by using the membrane filtration technique with standard methods agar and trypticase soy agar as the standards for comparison. Each assay system was challenged with dialysate and reverse-osmosis water from local dialysis centers, aqueous suspensions of eight laboratory strains of gram-negative bacilli and nontuberculous mycobacteria, and a mixed microbial flora inoculated into reverse-osmosis water and laboratory-prepared dialysate. Mean viable counts from triplicate samples were obtained after incubation at 37°C for up to 72 h. The efficiency of recovery varied with the specific type of microbial challenge. The SPC water sampler (Millipore Corp., Bedford, Mass.) was the most consistent in obtaining the highest viable counts. Other commercial systems were comparable to each other in overall performance. All assay systems tested provided an acceptable balance between microbial recovery and required sampling time, equipment, and expertise.
Background: Patients under hemodialysis are exposed to remarkable volume of water. As dialysis water is in direct contact with patients' blood, absence of regular disinfection of pipes will facilitate the transfer of the endotoxins produced by bacteria in water to the patient's body. Thus, regular control of dialysis system and water disinfectant equipment is compulsory. This study aimed at comparing relative frequency of positive culture for microorganisms in piped water before and after filtration, culture of water after passing from pipes, and culture of dialysis fluid before entering the dialysis filter in hemodialysis section of Alzahra Medical Center (Isfahan, Iran). Methods: During 2010 and 2012, an interventional study was performed in Alzahra Hospital. Samples were taken from piped water before and after filtration and from dialysis fluid before passing from membrane. The obtained samples were cultured in tryptic soy agar (TSA) and the isolated bacteria were then evaluated. Interventions included the disinfection of pipes used for transmission of water and replacement of pipes in hemodialysis section. Findings: Purified water was studied before and after passing the pipes. Dialysis fluid was also assessed before and after the intervention. Bacteria had grown in eight out of 14 samples (57%) before the intervention. In fact, five samples developed Escherichia coli, three had pseudomonas, and one had candida. However, after the intervention, only one out of 14 samples was found to have bacteria (alcaligenes) after filtration and before entering dialysis water pipes. Conclusion: According to the results of this study, the probability of bacterial growth is very high in filtration system of dialysis water. Regular disinfection and microbial sampling and culture are hence crucial.
Effect of High-Flux versus Low-Flux Dialysis on the Rate of Bacteremia in Hemodialysis Patients
Journal of Renal and Hepatic Disorders, 2021
Bacteremia in dialysis patients is a major risk factor of mortality. The aim of this study was to assess the effectiveness of dialysis with high-flux versus low-flux dialyzer regarding risk of bacteremia in dialysis patients. This was a retrospective cohort study that included dialysis patients who underwent dialysis therapy at old dialysis center where old low-flux dialyzers were used and the new dialysis center where high-flux dialyzers were used. The rate of positive culture was more in high-flux group (37.0%) compared to low-flux group (24.5%), although the difference was not statistically significant (P = 0.13). The vascular access was mostly permanent catheter in high-flux group compared to low-flux group (48.9% vs. 28.6%, respectively; P = 0.06), while arteriovenous (AV) fistula was more prominent in low-flux group compared to high-flux group (65.3% vs. 47.8%, respectively; P = 0.06). This was reflected in the type of bacteria, which was mostly from Gram-positive family (Stap...