Amir Keshvari, Mahboob Lesan Pezeshki, Masoud Younesian,
Volume 64, Issue 6 (3 2006)
Abstract
Background: The aim of this study was to evaluate the mechanical and infectious complications of continuous ambulatory peritoneal dialysis catheter in surgical wards of Imam Khomeini Hospital.
Methods: We retrospectively reviewed 80 catheters that were inserted into 69 patients (52 men and 28 women) with end-stage chronic renal failure during a period of 84 months (13 Nov. 1996 to 13 Nov. 2003.
Results: The mean age of patients was 48:35 years (16 to 79 years). The most common complications were infectious ones (71.25%), while the most common causes of the catheter removal were mechanical ones (46.5% vs. 39.55%. The predominate cause of the mechanical complications was improper position (17.5%). Migration of catheter to upper abdomen and outflow failure were the other common mechanical complications. The most common infectious complication was peritonitis (62.5%).
Conclusions: The occurrence of the mechanical complications is lower than the infectious ones, but the probability of catheter loss is higher if it occurs.
Hadadi A, Rasoulinejad M, Maleki Z, Mojtahedzadeh M, Younesian M, Ahmadi S.a, Bagherian H,
Volume 65, Issue 4 (3 2007)
Abstract
Background: The object of this study was to investigate the antimicrobial resistance pattern among common nosocomial Gram-negative bacilli isolated from patients with nosocomial infections.
Methods: From June 2004 to December 2005, 380 isolates of common Gram-negative bacilli (Klebsiella, Pseudomonas, Acinetobacter and E. coli) from 270 patients with nosocomial infections in Sina and Imam Hospitals, Tehran, Iran, were evaluated for susceptibility to Imipenem, Cefepime, Ciprofloxacine, Ceftriaxone and Ceftazidime by Disc diffusion and E-test methods.
Results: The most frequent pathogens isolated were Klebsiella spp. (40%), followed by Pseudomonas (28%), Acinetobacter spp. (20%) and E. coli (12%). The most active antibiotic was imipenem (84%). 26% of all isolates were sensitive to Cefepime, 26% to Ciprofloxacin, 20% to Ceftazidime and 10% to Ceftrixone. The susceptibility rates of Klebsiella to Imipenem, cefepime, ciprofloxacin, Ceftazidime and Ceftriaxone were 91, 25, 21, 13 and 7 percent, respectively and 91, 19, 17, 21 and 21 percent, respectively, for E. coli. Among Acineto- bacter spp., the susceptibility rate was 77% for Imipenem and 21% for Ciprofloxacin. Among Pseudomonas spp., 75% of isolates were susceptible to Imipenem and 39% to Ciprofloxacin. The comparison of the resistance status of microorganisms by both Disc diffusion and E-test methods showed a clinically noticeable agreement between these two tests.
Conclusions: Since antibiotic resistance among Gram-negative bacilli has increased, enforcement of policy regarding proper antibiotic use is urgently needed in order to delay the development of resistance. Although it is widely accepted that E-test is more accurate in determining the resistance of microorganisms, our study showed that the Disc diffusion test will give the same results in most occasions and is therefore still considered useful in clinical practice.
