Impact of active surveillance and infection control measures on carbapenem-resistant Gram-negative bacterial colonization and infections in intensive care.

Background: Carbapenem-resistant Gram-negative bacteria (CRGNB) infections constitute a global threat for critically ill patients and the outcome of their hospitalization. Early identification of CRGNB through rectal surveillance cultures and routine infection control measures including contact precautions, use of appropriate disinfectants, staff education on cleaning, and hand hygiene may reduce the dissemination of CRGNB.

Aim: To assess the impact of enhanced infection control measures on CRGNB infections in a nine-bed polyvalent intensive care unit in a tertiary level hospital in an endemic area.

Causes and incidence of renal replacement therapy application in orthotopic liver transplantation patients: our experience.

Background: Renal dysfunction is commonly found in patients with end-stage liver disease, as well as after liver transplantation, and it often needs renal replacement therapy (RRT) with the application of continuous or intermittent methods. The aim of this study was the recording of the patients who underwent continuous venovenous hemodiafiltration (CVVHDF) in the early postoperative period, as well as the recording of mortality and risk factors.

Methods: We retrospectively examined 71 patients who underwent orthotopic liver transplantation during a 2-year period (2011-2012).

Comparison of RIFLE and AKIN criteria in the evaluation of the frequency of acute kidney injury in post-liver transplantation patients.

Background: Acute renal dysfunction is presented quite often after orthotopic liver transplantation (LT), with a reported incidence of 12-64%. The "RIFLE" criteria were introduced in 2004 for the definition of acute kidney injury (AKI) in critically ill patients, and a revised definition was proposed in 2007 by the Acute Kidney Injury Network (AKIN), introducing the AKIN criteria. The aim of this study was to record the incidence of AKI in patients after LT by both classifications and to evaluate their prognostic value on mortality.

Tigecycline for treatment of carbapenem-resistant Klebsiella pneumoniae infections after liver transplantation in the intensive care unit: a 3-year study.

Background: This 3-year prospective, observational, single-center study was undertaken to describe prescription, microbiology findings, tolerance, and efficacy of tigecycline for carbapenem-resistant Klebsiella pneumoniae (CRKP) infections after liver transplantation in the intensive care unit (ICU).

Methods: All patients after liver transplantation treated with tigecycline for ≥3 days for CRKP infections in our ICU from January 1, 2010, to December 31, 2012, were studied. Patient characteristics, indication of treatment, bacteriology, and ICU mortality were collected.

Bloodstream infections caused by carbapenemase-producing Klebsiella pneumoniae among intensive care unit patients after orthotopic liver transplantation: risk factors for infection and impact of resistance on outcomes.

Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) has emerged as an important cause of bloodstream infections in intensive care units (ICUs). The aim of this study was to determine risk factors for bloodstream infections caused by CRKP as well as risk factors for CRKP-associated mortality among ICU patients after orthotopic liver transplantation (LT).

Methods: The study cohort of this observational study comprised 17 ICU patients after LT with CRKP bloodstream infections.

Impact of the Model for End-stage Liver Disease (MELD) score on liver transplantation in Greece.

Introduction: The impact of preoperative Model for End-stage Liver Disease (MELD) score in postoperative mortality remains unclear. The assumption that patients with a higher MELD score will have a higher mortality rate is not confirmed and studies are contradictory.

Aim: The study of the clinical course of patients with a higher MELD score and its impact in immediate and later mortality in comparison with patients with a lower MELD score in the only liver transplantation center in Greece.

Preterm delivery in a parturient candidate for emergency liver transplantation after hepatitis B virus infection related fulminant liver failure.

This case shows the development of fulminant hepatic failure due to acute hepatitis B virus infection in a multipara (32(nd) week of gestation) candidate for an emergency liver transplantation. Preterm labor began and she delivered a preterm healthy male baby. Postpartum, there were complications including a massive hemorrhage that was managed adequately.

Infections after orthotopic liver transplantation in the intensive care unit.

Purpose: The purpose of the study was to assess the characteristics and risk factors of infections in the early period after orthopic liver transplantation (OLT) among adult patients.

Material And Methods: We studied 75 patients who underwent OLT over 3 years from 2008 to 2010. We recorded all infections that developed during hospitalization in the intensive care unit (ICU) their outcomes, and the possible risk factors.

Acute kidney injury after orthotopic liver transplantation.

Acute kidney injury (AKI), one of the most frequent complications in the early period after liver transplantation, causes serious obstacles in the management of these patients affecting their outcomes. We studied retrospectively 79 subjects who underwent orthotopic liver transplantation (OLT). AKI was defined as an elevation of serum creatinine 1.

The effect of hyponatremia on the outcome of patients after orthotopic liver transplantation.

Predicting the prognosis of cirrhotic patients is considered to achieve a fair allocation among patients awaiting orthotopic liver transplantation (OLT). Serum sodium (Na) concentrations are associated with reduced survival among patients with cirrhosis. The mortality risk of cirrhotic patients, as defined by the Model for End-Stage Liver Disease (MELD) score, is considered to be higher in hyponatremic patients.

Infections related to renal transplantation requiring intensive care admission: a 20-year study.

Introduction: The aim of this study was to evaluate infection complications as the reason for intensive care unit (ICU) admission among transplant recipients.

Methods: We studied all renal transplant recipients with infectious complications admitted to our ICU from 1992 to 2012:44.3% of all renal transplant recipients admitted to ICU.

Course and outcome of renal transplant recipients admitted to the intensive care unit: a 20-year study.

Background: Renal transplantation represents the main treatment for end-stage renal disease. The goal of this study was to evaluate the course and outcome of renal transplant recipients admitted to the intensive care unit (ICU) and to analyze factors determining prognosis and mortality.

Methods: The demographic features, data admission characteristics, and ICU courses of all renal transplant recipients admitted to our ICU from 1992 to 2012 were evaluated to analyze factors for mortality.

Attitudes and behavior toward organ donation in Greece.

Introduction: During the two last decades remarkable progress has been made among transplantations in Greece. However, organ donation remains a controversial issue.

Purpose: To explore and determine factors associated with differences in willingness to donate organs among Greeks.

Bloodstream infections caused by metallo-β-lactamase/Klebsiella pneumoniae carbapenemase-producing K. pneumoniae among intensive care unit patients in Greece: risk factors for infection and impact of type of resistance on outcomes.

Objective: To determine risk factors for bloodstream infections (BSIs) caused by Klebsiella pneumoniae producing metallo-β-lactamases (MBLs) or K. pneumoniae carbapenemases (KPCs), as well as risk factors for mortality associated with carbapenem-resistant K. pneumoniae, among intensive care unit (ICU) patients.

The level of teamwork as an index of quality in ICU performance.

Background: The benefits of improved interdisciplinary collaboration in the health care section are well documented in the literature, including fewer errors and shorter delays and thus enhanced effectiveness and maximised patient safety. Given that the first step in improving teamwork involves uncovering individual team member's attitudes, this study was planned to investigate the level of collaboration, as part of organizational culture in the environment of ICU in Hippokratio Hospital.

Methods: Considering as team all the medical and nursing stuff necessary for the integraded care of the ICU-patient, all the ICU personnel was included in the study, as well as that of other cooperating clinical departments and labs of Hippokratio hospital.