The CLOCK trial, a double ‐blinded randomized controlled trial: Trisodium citrate 30% and minocycline 3 mg/mL plus EDTA 30 mg/mL are effective and safe for catheter patency maintenance among CKD 5D patients on hemodialysis
Abstract Introduction Poor blood flow rate (PF) is highly prevalent among CKD 5D patients with long‐term central venous catheters. Heparin catheter lock solutions are commonly used to maintain catheter patency, however the incidence of PF remains high. The purpose of the CLOCK Trial was to evaluate two catheter lock solutions on reduction of PF incidence. Methods Seventy‐five CKD 5D patients on high‐efficiency hemodialysis at the Integrated Centre of Nephrology (Guarulhos, Brazil) were randomized 1:1:1 to receive a lock solution combining minocycline 3 mg/mL with the anticoagulant/chelation agent EDTA 30 mg/mL (M‐EDTA) or heparin 1000 IU/mL (H) or trisodium citrate 30% (TSC) vs. Hfor 15 weeks. A total of 68 patients completed the trial in which both investigators and patients were blinded to treatment allocation. The primary end‐point was the occurrence of hydraulic resistance and secondary safety end‐point was adverse drug reactions related to the lock solutions. Findings At the beginning of the trial, 7 patients were excluded from this trial due to their poor catheter care. The incidence of hydraulic resistance was significantly higher among patients on H (18/23) compared to TSC (4/22) and M‐EDTA (2/23) lock solutions, (P
ConclusionsOur data suggest that fosfomycin has good effect against mucoid and non-mucoid strains of P. aeruginosa and automated systems can be implemented in clinical microbiology laboratories to assess fosfomycin with rapid and reproducible results.
ConclusionsIn this study, the majority of MRSE belonged to cluster II domain of CC2. The ST59-IV was a dominant clone among isolates recovered from hospital personnel. Determination of new MLST types confirmed the genetic diversity of these isolates. These observations highlight the need to review the infection control strategies to reduce the carriage of MRSE among hospital personnel.
ConclusionsAn alarming rate of phenotypic resistance was observed in this study. Many isolates were positive for the screened resistance genes. According to the phylogenetic background, most resistant isolates belonged to the commensal phylo-types, representing significant role of commensal strains as a source of resistance genes. These findings highlight the role of pigeon as disseminator of resistant E. coli strains.
Publication date: Available online 22 February 2020Source: Journal of Global Antimicrobial ResistanceAuthor(s): Marisa Haenni, Farid El Garch, Christine Miossec, Jean-Yves Madec, Didier Hocquet, Benoit Valot
Empirical gonorrhea treatment at initial diagnosis reduces onward transmission. However, increasing resistance to multiple antibiotics may necessitate waiting for culture-based diagnostics to select an effective treatment. There is a need for same-day culture-free diagnostics that identify infection and detect antimicrobial resistance. We investigated if Nanopore sequencing can detect sufficient Neisseria gonorrhoeae DNA to reconstruct whole genomes directly from urine samples. We used N. gonorrhoeae-spiked urine samples and samples from gonorrhea infections to determine optimal DNA extraction methods that maximize the amo...
ConclusionsThe prospective surveillance and active screening for VRE was very useful to determine the true ratio of intestinal colonization to infection and thus helps to shape infection control management.
Publication date: Available online 21 February 2020Source: American Journal of Infection ControlAuthor(s): Aleksa Despotovic, Branko Milosevic, Ivana Milosevic, Nikola Mitrovic, Andja Cirkovic, Snezana Jovanovic, Goran StevanovicBackgroundAcquisition of Hospital-acquired infections (HAIs) in intensive care units (ICUs) predispose patients to higher mortality rates and additional adverse events. Serbian adult ICUs are rarely investigated for HAIs. The aim of this study was to look into HAIs in an adult ICU and identify risk factors for acquisition of HAIs and mortality.MethodsThis retrospective study included 355 patients h...
This article reviews the antimicrobial action of ROS, challenges to ROS hypothesis, researches to encourage ROS–mediated antimicrobial lethality, recent developments in antimicrobial agents using ROS as an antimicrobial strategy, safety concerns related to ROS, and future directions in ROS research.
Authors: Blakiston MR, Freeman JT Abstract AIMS: National responses to antimicrobial resistance (AMR) require an understanding of the factors driving its development and spread. Research to date has primarily focused on determining individual-level risk factors for AMR-associated infections. However, additional insights may be gained by investigating exposures associated with AMR variation at the population level. METHODS: We used an ecological study design to describe the association between the incidence rate of methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum β-lactamase producin...