Amuchina 10% solution, safe antiseptic for preventing infections of exit-site of Tenckhoff catheters, in the pediatric population of a dialysis program.

Although, decreasing in incidence with the disconnection systems, the first complication is still peritonitis in patients with chronic renal failure and the second is infection of Tenckhoff catheter exit-site. All efforts made to diminish the frequency of exit-site infection lower the possibility of peritonitis. The pediatric population is well-known to have a major risk of infectious complications, and making easy and safe the care of the exit-site will prevent the peritonitis that follows. The aim of the study was to evaluate the efficacy of the Amuchina 10% solution vs. pH neutral soap in children with chronic renal failure, on preventing exit-site infection. There were 60 patients who were assigned randomly to one of two groups. One group used Amuchina 10% solution for the daily cleaning of the exit-site, and the other used pH neutral soap, with 14 months of follow-up. Before the study they have to be free of infection for at least 30 days. All were taught by the same nurse how to clean their exit-site. Groups were almost identical in years, sex, and time on dialysis. We had nine infections in the soap group and none in the Amuchina 10% solution group, with an OR: 17 (p = 0.004). From these nine infections, the bacteria isolated were: 4 (13%) were caused by Pseudomona aeruginosa, 1 (3.3%) by Staphylococcus aureus, coagulase-positive staphylococci in 2 (6.6%) and Serratia marcensens in 1 (3.3%). In conclusion, Amuchina 10% solution is effective in preventing infection on the exit-site, without any secondary topical reaction.

Effect of low-dose cyclosporine A in the treatment of refractory proteinuria in childhood-onset lupus nephritis.

We performed a prospective study to evaluate the efficacy and safety of low-dose cyclosporine A (CSA) treatment in paediatric lupus nephritis refractory to conventional therapy. Seven children with biopsy-proven Class III-IV lupus nephritis were treated with CSA (2-4 mg/kg/day) combined with low-dose prednisone for one year. All patients had failed to achieve sustained proteinuria remission with corticosteroids and cytotoxic drugs. Proteinuria decreased from median value of 2.5 g/24 hours (range, 1.2-4.9) to 0.14 g/24 hours (range, 0.0-0.84) after treatment (P = 0.018). Median values of creatinine clearance and serum creatinine did not change significantly. Median systemic lupus erythematosus disease activity index score decreased from 12 (range, 6-16) to 4 (range, 0-8) at end of treatment (P = 0.027). However, two patients experienced flares of extrarrenal manifestations and complement levels did not improve. Moreover, most patients relapsed with proteinuria within a few months of stopping CSA therapy. Side effects were not significant. In conclusion, low-dose of CSA combined with steroids appears to be useful to reduce proteinuria in paediatric proliferative lupus nephritis refractory to steroids and cytotoxic drugs; however, relapses are common after CSA discontinuation. Further studies are needed to define the precise role of CSA in paediatric lupus nephritis.

PCR identification of Salmonella: potential contamination sources from production and postharvest handling of cantaloupes.

Salmonella is one of the most frequently reported etiological agents in outbreaks of foodborne diseases associated with the consumption of cantaloupes. Sensitive and reliable methods for detecting and identifying foodborne microorganisms are needed. The PCR can be used to amplify specific DNA fragments and thus to detect and identify pathogenic bacteria. In this study, a PCR method was used to evaluate the incidence of Salmonella at cantaloupe production, harvest, and packaging steps, and the results were compared with those of the standard method for detection of Salmonella in foods (Mexican NOM-114-SSA1-1994). Salmonella was detected by both standard and PCR methods in 23.5% of the irrigation water samples but only by the PCR method in 9.1% of the groundwater samples, 4.8% of the chlorinated water samples, 16.7% of samples from the hands of packing workers, 20.6% of samples from the packed cantaloupes, and 25.7% of samples from the in-field cantaloupes. With the standard method, Salmonella was found in 8.3% of the crop soil samples. Statistical analysis indicated a significant difference in sensitivity (P < 0.05) between the two methods; the PCR method was 4.3 times more sensitive than the standard method. Salmonella was found at seven of the eight pointsevaluated during the production and postharvest handling of cantaloupe melons.