Diagnosis, treatment and follow-up of 25 patients with melamine-induced kidney stones complicated by acute obstructive renal failure in Beijing Children's Hospital.

A total of 25 Chinese patients aged 6 to 36 months hospitalised at Beijing Children's Hospital due to melamine-induced kidney stones complicated by acute obstructive renal failure in 2008 were included in a study in order to diagnose and treat these special cases more effectively. Feeding history, clinical presentation, ultrasound findings, treatments and effects were summarised. Twelve to seventeen months follow-up was reported also. Ultrasound examination showed that calculi were located at the kidney and ureters. Stones were composed of both uric acid and melamine in a molar ratio of 1.2:1 to 2.1:1. Treatments providing liquid plus alkalisation of urine proved to be effective in helping the patients pass the stones. Surgical intervention was needed in severe cases. Renal function returned to normal in all 25 patients after various durations of therapy. Sixty-eight percent of the patients expelled all of the calculi within 3 months, 90% in 6 months and 95% in 9 months, without sequelae till now. Melamine-contaminated milk formula can cause kidney stones in infants, which should be diagnosed by feeding history, clinical symptoms and ultrasound examination. Composition of the stones was not only of melamine but also uric acid. Providing liquid orally or intravenously plus alkalisation of urine proved to promote the removal of the stones. Follow-up of 12 to 17 months after discharge showed no sequelae.

The potential of Escherichia coli in enteral feeds to cause food poisoning: a study under simulated ward conditions.

The growth of Escherichia coli over a period of 8 h under simulated ward conditions was compared in feeding systems containing either Clinifeed ISO or Nutrient Broth. In both, counts increased from 10(2) to 10(7) ml-1. Other systems containing Clinifeed ISO were inoculated with E. coli and sampled over 24 h. At 8 and 16 h the contaminated reservoir was replaced, refilled or replaced together with the gastric drip line. When the reservoir was replaced or refilled it was always recontaminated by residual organisms. Even when the reservoir and drip line were replaced, although the contents of the reservoir were sterile, E. coli was still detected in feed collected from the end of the fine-bore tube. Experiments with varying numbers of E. coli in the inoculum demonstrated that even one organism in the reservoir could, within 16 h, multiply to a level that might be harmful, especially to compromised patients.