ABSTRACT
BACKGROUND: The main study aim was to track infections, evaluate performance, and identify opportunities for improved practice since infections, especially those associated with multidrug-resistant organisms, are the second most common cause of death among end-stage renal disease patients. METHODS: This study describes the establishment of baseline dialysis event surveillance at a large dialysis center. Every month, the dialysis center staff reported the total number of maintenance hemodialysis patients to the department of infection control and hospital epidemiology. The surveillance system for dialysis events included monthly monitoring of hemodialysis patients in outpatient settings for positive blood cultures, intravenous antimicrobial initiation, and local vascular access infections. RESULTS: We calculated the pooled mean rates of positive blood cultures, intravenous antimicrobial initiation, and local vascular access infections during the period from June 1, 2014 to September 30, 2017. Results indicated more dialysis events were attributed to the CVC than any other dialysis vascular access. Regardless of vascular access type, intravenous antimicrobial initiation was the most commonly reported dialysis-associated event. CONCLUSIONS: Dialysis events surveillance can be used to produce a decrease in both morbidity and mortality rates in hemodialysis patients.
Subject(s)
Arteriovenous Fistula/microbiology , Bacteremia/microbiology , Bacterial Infections/microbiology , Catheter-Related Infections/microbiology , Kidney Failure, Chronic/therapy , Renal Dialysis , Administration, Intravenous , Adult , Aged , Anti-Bacterial Agents/therapeutic use , Arteriovenous Fistula/drug therapy , Arteriovenous Fistula/etiology , Arteriovenous Fistula/prevention & control , Bacteremia/drug therapy , Bacteremia/etiology , Bacteremia/prevention & control , Bacterial Infections/drug therapy , Bacterial Infections/etiology , Bacterial Infections/prevention & control , Blood Culture , Catheter-Related Infections/drug therapy , Catheter-Related Infections/etiology , Catheter-Related Infections/prevention & control , Central Venous Catheters/adverse effects , Female , Humans , Male , Middle Aged , Monitoring, Physiologic , Outpatients , Retrospective Studies , Vancomycin/therapeutic useABSTRACT
Reversible posterior leukoencephalopathy syndrome (RPLS) is a neurological syndrome characterized by headache, seizures, and visual loss, often associated with an abrupt increase in blood pressure. It was first described by Hinchey and colleagues in 1996 when they described a case series. RPLS has been described in number of medical conditions, renal dysfunction being one of them. Prompt diagnosis and therapy with antihypertensives, anticonvulsants, removal of any offending medication, and treatment of associated disorder are essential because early treatment might prevent progression to irreversible brain damage. Here, we report a case of young man with focal segmental glomerulosclerosis (FSGS) and heavy proteinuria, who developed classical, clinical, and neurological features of RPLS with complete recovery.
