Cefotaxime-heparin lock prophylaxis against hemodialysis catheter-related sepsis among Staphylococcus aureus nasal carriers.

Staphylococcus aureus nasal carriers undergoing hemodialysis (HD) through tunneled cuffed catheters (TCCs) form a high-risk group for the development of catheter-related bloodstream infections (CRBSI) and ensuing morbidity. The efficacy of antibiotic-locks on the outcomes of TCCs among S. aureus nasal carriers has not been studied earlier.

Enhancing the survival of tunneled haemodialysis catheters using an antibiotic lock in the elderly: a randomised, double-blind clinical trial.

Background: Tunneled-cuffed catheters (TCC) are often used among the elderly to commence and carry out haemodialysis (HD). Complications like infection and thrombosis frequently reduce the lifespan of TCC. The role of an antibiotic heparin 'lock' in the prevention of thrombotic and infectious complications and enhancement of TCC survival in the elderly has not been investigated previously.

The impact of catheter-restricted filling with cefotaxime and heparin on the lifespan of temporary hemodialysis catheters: a case controlled study.

Background: Reduction in the rates of major complications such as infection and thrombosis that limit the lifespan of hemodialysis (HD) catheters could conceivably lead to improved survival of "temporary" non-tunneled HD catheters (NTCs). This study was designed to evaluate the impact of the "locking"' of a broad-spectrum antibiotic-cefotaxime with heparin, on the incidence of catheter thrombosis, catheter-related bloodstream infections (CRBSI) and the NTC lifespan.

Methods: This prospective study included 208 (109 males and 99 females) end-stage renal disease (ESRD) patients of diverse etiology enrolled for long-term HD from July 2002 to June 2003 at our tertiary care hospital.

Prevalence of methicillin-resistant and methicillin-sensitive Staphylococcus aureus nasal colonization among patients at the time of admission to the hospital.

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is an important agent of hospital-acquired infection. The mode of entry of MRSA in the hospital might be on admission of patients with MRSA infection or nasal colonization. The present study was undertaken to determine the prevalence of MRSA nasal colonization among patients on admission to hospital.

Contamination of patients' files in intensive care units: an indication of strict handwashing after entering case notes.

Background: The extent to which bedside patients' files become contaminated and the range of bacterial flora attributable to contamination in high-risk areas of the hospital are not known with certainty. The aim of the present study was to determine the degree of contamination of the patient's files and also to analyze and compare the spectrum of contaminant bacterial flora between the intensive care unit (ICU) and surgical wards, the 2 most high-risk areas for nosocomial transmission of infection.

Methods: Microbiologic samples were collected from the exposed outer surface of the patients' files kept bedside in the ICU and surgical wards with sterile swabs moistened with sterile normal saline.

Prevention of catheter-related bloodstream infections: an appraisal of developments in designing an infection-resistant 'dream dialysis-catheter'.

With the increasing number of elderly, diabetics and debilitated patients being accepted for haemodialysis (HD), the use of central venous catheters (CVCs) as vascular access has become more widespread, with an inevitable inherent risk of catheter-related bloodstream infections (CRBSI) and ensuing mortality. No reliable plans for the effective management of CRBSI without actually sacrificing vascular access sites are presently available. Therefore, the onus really falls on renal physicians to make effective use of the established supportive guiding principles, practices, policies and programs to prevent CRBSI among HD patients.

Haemodialysis catheter-related bloodstream infections: current treatment options and strategies for prevention.

Regardless of the repeated reservations raised by countless researchers with reference to the use of catheters as vascular access for haemodialysis (HD), central venous catheters (CVCs) remain irreplaceable tools of the modern dialysis delivery system as a reliable option for the clinical situations requiring instant access to circulation, for various reasons. Patients on long-term haemodialysis are therefore at a significantly high risk for catheterrelated bloodstream infections (CRBSI) and ensuing serious complications. Although early systemic antibiotic treatment should include the coverage for Staphylococcus aureus, the pathogen with most devastating consequences including bacterial endocarditis; optimal treatment of CRBSI while preserving the catheter site, remains contentious.

Epidemiology of antibody to hepatitis B core antigen screening among blood donors in Eastern Saudi Arabia. Need to replace the test by HBV DNA testing.

Objective: Prevention of the residual risk of transfusion transmitted hepatitis B virus (HBV) infection is mostly relied on serological screening of blood donors for antibody to hepatitis B core antigen (HBc), to detect donors in window period of HBV infection. This study was carried out to determine the prevalence of anti-HBc antibody among blood donors and its impact on rejection of collected blood units.

Methods: Blood bank records of all the blood donors who donated blood at blood bank of King Fahad Hospital, Al-Hofuf, Kingdom of Saudi Arabia, during the period of 2000 to 2003 were reviewed.

Extended-spectrum beta-lactamase-producing Klebsiella pneumoniae hospital acquired bacteremia. Risk factors and clinical outcome.

Objective: To study the risk factors and clinical outcome in patients having extended-spectrum beta-lactamase producing (ESBL) Klebsiella pneumoniae (K. pneumoniae) hospital acquired bacteremia.

Methods: The study was conducted at 500 bedded King Fahad Hospital and Tertiary Care Center, Al-Hofuf, Al-Hasa, Eastern Province of Saudi Arabia.

Subcutaneous dirofilariasis caused by Dirofilaria repens.

Human dirofilariasis caused by Dirofilaria repens D. repens is a common zoonosis in the Mediterranean countries and parts of South Asia. During the last decade, it has been reported from countries previously considered non-endemic.

Prevalence of human T-lymphotropic virus type I and type II antibody among blood donors in Eastern Saudi Arabia.

Objective: Human T-cell leukemia/lymphoma virus type I and type II (HTLV-I/II) infections can be transfusion associated, leading to tropical paraparesis, myelopathy and other neurological disorders. The aim of this study is to circumvent the risk of transmission through blood transfusion and to describe the prevalence of HTLV-I/II antibody among blood donors of Al-Hasa region and the cost effectiveness of screening blood donors.

Methods: The study was conducted at the Department of Laboratory and Blood Bank, King Fahad Hospital, Al-Hofuf, Al-Hasa, Kingdom of Saudi Arabia during the period of 1997 to 2003.

Emergence of nalidixic acid resistance in Shigella sonnei isolated from patients having acute diarrheal disease: report from eastern province of Saudi Arabia.

During the 5 years of the study period (October 1999-October 2003), 110 strains of Shigella were isolated from fecal samples of patients having acute diarrheal diseases. Shigella sonnei phase 1 was the most prevalent (88/110, 80.0%) serotype.

The vulnerability of middle-aged and elderly patients to hepatitis C virus infection in a high-prevalence hospital-based hemodialysis setting.

Objectives: To determine the relationship between advancing age and the risk of acquiring hepatitis C virus (HCV) infection, through evaluation and statistical comparison of seroprevalence and seroconversion rates in different age groups of patients on long-term hemodialysis (HD).

Design: Retrospective cohort study.

Setting: Hemodialysis facility of King Fahad Hospital and Tertiary Care Center, Al-Hasa region of the eastern province of Saudi Arabia.