Acute kidney injury (AKI) is a frequent complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT), but few studies have focused on AKI treated with kidney replacement therapy (AKI-KRT), particularly among critically ill patients. We investigated the incidence, risk factors, and 90-day mortality associated with AKI-KRT in 529 critically ill adult allo-HSCT recipients admitted to the ICU within 1-year post-transplant at two academic medical centers between 2011 and 2021. AKI-KRT occurred in 111 of the 529 patients (21.0%). Lower baseline eGFR, veno-occlusive disease, thrombotic microangiopathy, admission to an ICU within 90 days post-transplant, and receipt of invasive mechanical ventilation (IMV), total bilirubin ≥5.0 mg/dl, and arterial pH <7.40 on ICU admission were each associated with a higher risk of AKI-KRT. Of the 111 patients with AKI-KRT, 97 (87.4%) died within 90 days. Ninety-day mortality was 100% in each of the following subgroups: serum albumin ≤2.0 g/dl, total bilirubin ≥7.0 mg/dl, arterial pH ≤7.20, IMV with moderate-to-severe hypoxemia, and ≥3 vasopressors/inotropes at KRT initiation. AKI-KRT was associated with a 6.59-fold higher adjusted 90-day mortality in critically ill allo-HSCT vs. non-transplanted patients. Short-term mortality remains exceptionally high among critically ill allo-HSCT patients with AKI-KRT, highlighting the importance of multidisciplinary discussions prior to KRT initiation.
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http://dx.doi.org/10.1038/s41409-023-02136-8 | DOI Listing |
Front Cell Infect Microbiol
December 2024
Medical Laboratory, Kunming Children's Hospital, Children's Hospital Affiliated to Kunming Medical University, Kunming, Yunnan, China.
Sepsis is a systemic inflammatory response syndrome of multiorgan failure caused by dysregulation of the host response to infection and is a major cause of death in critically ill patients. In recent years, with the continuous development of sequencing technology, the intestinal microecology of this disease has been increasingly studied. The gut microbiota plays a host-protective role mainly through the maintenance of normal immune function and the intestinal barrier.
View Article and Find Full Text PDFMed Sci Monit
December 2024
Department of Paediatric Intensive Care, Emma Children's Hospital, Amsterdam UMC, Meibergdreef, Netherlands.
BACKGROUND Patient monitoring systems (PMSs) are essential for monitoring and managing the condition of critically ill patients. In low-resource settings, limited access to technology, low-level digital literacy, and power outage challenges are usability concerns. The main aim of this study was to evaluate the usability of the IMPALA (Innovative Monitoring in Paediatrics in Low-resource settings: an Aid to save lives) PMS optimized for use in low-resource settings by assessing the opinions and experiences of 24 healthcare professionals.
View Article and Find Full Text PDFBMC Infect Dis
December 2024
Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
Background: The World Health Organization (WHO) has identified carbapenem-resistant Pseudomonas aeruginosa (CRPA) as one of the three critical priority pathogens. There is scarce literature evaluating the treatment outcomes in patients with CRPA infections treated with traditional non-carbapenem β-lactam (NCBL) agents. Thus, this study aims to assess the effectiveness of traditional NCBL compared to novel β-lactam agents (NVL) for treating non-carbapenem β-lactam -susceptible CRPA.
View Article and Find Full Text PDFAPMIS
January 2025
Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Colistin is a last-resort treatment for multidrug-resistant Gram-negative bacterial infections, particularly in critically ill patients. Nevertheless, it remains a major threat to public health. We assessed the proportion of colistin-resistant Gram-negative isolates from intensive care unit (ICU) infections in different years, areas, pathogens, and antimicrobial susceptibility tests (AST).
View Article and Find Full Text PDFJ Food Prot
December 2024
Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention. 1600 Clifton Rd NE MS-H24-10, Atlanta, GA 30333, USA. Electronic address:
Listeria monocytogenes causes listeriosis, a serious infection, with a high mortality rate for persons at higher risk for listeriosis. The first Listeria outbreak linked to frozen vegetables occurred in 2016 and resulted in three deaths. Many frozen vegetables are intended to be consumed after cooking.
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