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La survenue d'une péritonite aiguë demeure une complication sévère de la dialyse péritonéale (DP). L'administration rapide d'antibiotiques, sans délais, permet d'en obtenir la guérison. L'administration intra-péritonéale (IP) des antibiotiques est compliquée et comporte le risque d'ajouter de nouveaux germes dans la cavité péritonéale; l'administration d'antibiotiques IP également a été associée à une péritonite chimique. Le but de cette étude est d'évaluer l'efficacité et la sécurité d'une administration systémique (intraveineuse et orale) de Vancomycine, Ciprofloxacine et Gentamicin chez les patients ayant une péritonite aïgue aux Cliniques Universitaires Saint-Luc entre le 01/01/2000 et le 30/06/2014, et d'identifier les facteurs associés à l'échec du traitement.Nous avons rétrospectivement identifié tous les épisodes de péritonite aïgues chez les patients en dialyse péritonéal aux Cliniques Universitaires Saint Luc entre le 01101/2000 et le 30/06/2014. La Vancomycine est administrée à la posologie a été injectée 20 mg/ kg de poids par voie intraveineuse, la Ciprofloxacine ,oralement, 250 mg deux fois par jour (500 mg deux fois par jour si la clairance de la créatinine résiduelle était supérieure à 3 ml / mn) et Gentamycine 80mg (l'ajout de Gentamycine a commencé à partir de 1/6/2009), dose unique, intraveineuse, au moment du diagnostic de la péritonite. Les caractéristiques démographiques, biochimiques et microbiologiques des patients. ont été enregistrées. Les résultats ont été défini en "premier" (Vancomycine/ Ciprofloxacine) ou "second" (Vancomycine/ Ciprofloxacine/ Gentamycine) protocole. L-e success du traitement a été define avec la guérison de la péritonite en première intention (Gl) ou après adaptation des antibiotiques (G2). L'échec du traitement ont été défini comme le décès du patient dû à une péritonite, le nécessité du retrait du cathéter ou la rechute de péritonite. Les épisodes de mauvais résultats ont été comparés avec ceux d'une réussite du traitement.175 épisodes de péritonite sont survenus chez 89 patients au cours de la période d'étude; 35 elpisodes de péritonite n'ont pas été inclues dans l'étude (33 violations de protocole et 2 patients perdus de vue); permettant donc d'analyser 140 épisodes de péritonite chez 86 patients. Cinquante et une (36,4%) péritonites étaient dûes à Gram positif et 37 (26,4%) à Gram-négatifs se sont dévéloppé, l'absence organisme identifié ne représentaient que 17,9% de tous les épisodes de péritonite, alors que 19,3% des péritonites étaient polymicrobiens . Le taux global de succès du traitement a été de 73,6% (71,7% avec le premier protocole et 79,4% avec le deuxième protocole). Un nombre de globules blancs > 1700 cellules/ µl le 3ème jour de la péritonite prédit l'échec du traitement avec une sensibilité de 61,1% et une spécificité de 96,1%. En comparison avec les données associées à un bon prognostics , les facteurs associés à de mauvais résultats sont de plus grand âge (61,28 vs 52,37, p = 0,02), un comorbidité de Charlson score plus élevé (moyenne 5,62 vs 4.41 , p = 0,007), la présence de diabète (34,4% vs 18,5%, p = 0,09), des niveaux de CRP plus élevée après 3 jours de traitement (16,34 vs 8,26 mg/dl, p = 0,003), une numération de globules blancs plus élevée dans le dialysat au jour de l'admission (6604 vs 4879/µl, p = 0,02) et après 3 jours de traitement (4368 vs 395/µl, p <0,0001), la durée nécessaire du traitement (32,17 vs 21,16 jours , p = 0,003) et un nombre prolongés de jours d'hospitaiisation (17,41 vs 2,39 jours, p <0,0001)L'administration systémique de vancomycine , ciprofloxacine et la gentamicine est un protocole de première ligne d'antibiothique simple et efficace pour traiter la péritonite dialyse péritonéale. Les facteurs associés à un mauvais pronostic sont l'âge, un score de Charlson élevé, la presence d'un diabète, un taux élevé de CRP, un nombre élevé_ de globules blancs dans le dialysat, une durée prolongée de !'antibiothérapie et un nombre élevé de jours hospitalisatione . La numération des globules blancs dans le dialysat au 3ème jour de la péritonite semble être un paramètre non-invasif et prometteur pour prédire le pronostic de la péritonite en dialyse péritonéale. Acute peritonitis remains an important complication of peritoneal dialysis (PD). It requires prompt antibiotic administration. The usual intra-peritoneal (IP) antibiotic administration is cumbersome and carries the risks of adding new germs into the peritoneal cavity; also, IP administration of antibiotics has been associated with chemical peritonitis. The aim of this study is to review both the efficacy and safety of our protocol of systemic (intravenous and oral) administration of Vancomycin, Ciprofloxacin and Gentamycin in PD patients with acute peritonitis from Cliniques Universitaires Saint-Luc, Brussels,between 0110 1/2000 and 30/06/2014 and to identify factors associated with treatment failure.We retrospectively identified all PD-related peritonitis episodes at our center between 01/01/2000 and 30/06/2014. Vancomycin 20 mg/kg body weight, intravenous, Ciprofloxacin 250 mg two times per day (500 mg twice per day if residual creatinine clearance was above 3 mL/mn) and Gentamycin 80 mg (Gentamycin was started from 116/2009 onwards), single dose, intravenous were prescribed at the diagnosis of peritonitis . Results were divided into a "first" (Vancomycin/ Ciprofloxacin) and a "second"(Vancomycin/ Ciprofloxacin/ Gentamycin) protocol. Demographic, biochemical and microbiological data were recorded, for all patients. Successes of the protocol were defined as the cure of the infections, at the first intention (G 1) or after antibiotic adaptation (G2). Failure treatment was defined as death due to peritonitis, catheter removal or relapse peritonitis. Episodes with poor outcomes were compared with those with that were successfully cured.Results: A total of 175 peritonitis episodes occurred in 89 patients were enrolled during the study period; 35 peritonitis episodes were not included in the study (33 protocol violation and 2 patients lost for follow-up); giving 140 episodes of peritonitis in 86 patients. Fifty-one (36.4%) gram-positive and 37 (26.4%) gram-negative organisms were grown respectively, no organism identified accounted for 17.9% of ail peritonitis episodes, whereas polymicrobial peritonitis occurred in were 19.3%. The overall treatment success rate was 73.6% (71.7% with first protocol and 79.4% with second protocol). The dialysate total white cell (WC) count on day 3 of peritonitis with a cut point > 1700 cells/ µl predicted treatment failure with a good sensitivity of 61,l% and excellent specificity 96,1%. As compared to factors associated with a good prognosis, factors associated with poor outcome were increased age (61 vs 52, p=0.02), higher Charlson's score (mean 4.41 vs 5.62, p=0.007), diabetes (34.4% vs 18.5%, p=0.09), with higher serum CRP levels after 3 days of treatment (16.34 vs 8.26 mg/dl, p = 0.003), higher white cell counts in dialysate at day of admission (4879 cells/µl vs 6604 cells/µl, p=0.02) and after 3 days of treatment (395 cells/µ1 vs 4368 cells/µ1, p<0.0001), longer duration of antibiotic therapy (21.16 vs 32.17 days, p=0.003) and prolonged days of hospitalization (2.39 vs 17.41 days, p<0.0001)Systemic vancomycm, ciprofloxacin and gentamicin administration is a simple and efficient first-line protocol antibiotic therapy for PD peritonitis. Factors associated with poor outcome are older age, high comorbidity Charlson's score, diabetes, high CRP level, high dialysate white cell count, longer duration of antibiotic therapy and prolonged days of hospitalization. Dialysate white cell count at day 3 of peritonitis is confirmed to be a non-invasive and promising parameter to predict outcomes of dialysis-related peritonitis.
Peritoneal Dialysis --- Vancomycin --- Gentamicins --- Ciprofloxacin
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Glycopeptide antibiotics. --- Antibiotics, Glycopeptide. --- Vancomycin.
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As the infections caused by multidrug-resistant Gram-positive bacteria remain a worldwide issue in tenus of morbidity and mortality but also in terms of increased expenditure on patient management, important research in the field led to the introduction of a large number of novel antibacterial agents. Among the new antibiotics being developed against meticillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci, oritavancin a new lipoglycopeptide seems able to circumvent high level of glycopeptides resistance. The story behind this agent reveals the pharmaceutical business and regulatory challenge that can have a major impact on development of new antibiotics (Norris E. allen et coll, 2010). As the development of this agent started in 1985 and has not yet receives any approval, the aim of this paper is to determine whether or not there is a future for oritavancin
oritavancin --- telavancin --- Anti-Bacterial Agents --- Vancomycin
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Renal Insufficiency, Chronic --- Vancomycin --- Kidney Diseases
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Infection --- Methicillin resistance. --- Vancomycin resistance. --- Prevention.
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Bacterial diseases --- Vancomycin --- Drug resistance --- Geneesmiddelen --- Infectieziekten --- Bacteriologie --- Médicaments --- Maladies infectieuses --- Bactériologie
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Nanocelluloses: Synthesis, Modification and Applications is a book that provides some recent enhancements of various types of nanocellulose, mainly bacterial nanocellulose, cellulose nanocrystals and nanofibrils, and their nanocomposites. Bioactive bacterial nanocellulose finds applications in biomedical applications, https://doi.org/10.3390/nano9101352. Grafting and cross-linking bacterial nanocellulose modification emerges as a good choice for improving the potential of bacterial nanocellulose in such biomedical applications as topical wound dressings and tissue-engineering scaffolds, https://doi.org/10.3390/nano9121668. On the other hand, bacterial nanocellulose can be used as paper additive for fluorescent paper, https://doi.org/10.3390/nano9091322, and for the reinforcement of paper made from recycled fibers, https://doi.org/10.3390/nano9010058. Nanocellulose membranes are used for up-to-date carbon capture applications, https://doi.org/10.3390/nano9060877. Nanocellulose has been applied as a novel component of membranes designed to address a large spectrum of filtration problems, https://doi.org/10.3390/nano9060867. Poly(vinyl alcohol) (PVA) and cellulose nanocrystals (CNC) in random composite mats prepared using the electrospinning method are widely characterized in a large range of physical chemical aspects, https://doi.org/10.3390/nano9050805. Similarly, physical chemical aspects are emphasized for carboxylated cellulose nanofibrils produced by ammonium persulfate oxidation combined with ultrasonic and mechanical treatment, https://doi.org/10.3390/nano8090640. It is extraordinary how nanocellulose can find application in such different fields. Along the same lines, the contributions in this book come from numerous different countries, confirming the great interest of the scientific community for nanocellulose.
tensile strength --- amino acid --- poly (vinyl alcohol) --- Eu ion --- recycled fiber --- bacterial nanocellulose --- Fenton reagent --- cross-linking --- electrospinning --- biomedical applications --- complex --- fluorescent paper --- nanocomposite --- vancomycin --- reinforcement --- carbon source --- in situ modification --- facilitated transport --- water application --- scanning electron microscopy --- nanocellulose --- cellulosic fiber --- rheology --- polymer nanocomposites --- selective separation --- durability --- oxidation --- thermogravimetric analysis --- ex situ modification --- methacrylate --- nanofibrils --- bacterial cellulose --- ammonium persulfate --- high shear mixer --- ionic liquid --- tensile properties --- bioactive bacterial nanocellulose --- gas separation membranes --- CO2 separation --- dispersion --- cellulose nanocrystals --- ciprofloxacin
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This book provides important and updated information on current research devoted to urinary biomarkers. Urinary biomarkers are characteristics that can be objectively measured and evaluated as indicators of normal biological or pathogenic processes of pharmacological responses to therapeutic intervention.
Medicine --- poststreptococcal acute glomerulonephritis --- infection-related glomerulonephritis --- nephritis-associated plasmin receptor --- plasmin --- acute kidney injury --- renal biomarkers --- furosemide stress test --- functional assessment --- urine --- diabetic kidney disease --- kidney function --- proteomics --- mass spectrometry --- statistical clinical model --- machine learning --- acute tubulointerstitial nephritis --- immunology --- biomarkers --- chronic kidney disease --- differential diagnosis --- label-free quantification --- renal transplant --- extracellular vesicles --- acute rejection --- chronic rejection --- chronic allograft dysfunction --- calcineurin-inhibitor nephrotoxicity --- Polyomavirus associated nephropathy --- immunosuppression --- upper urinary tract obstruction --- kidney injury --- neutrophil gelatinase-associated lipocalin --- monocyte chemotactic protein-1 --- kidney injury molecule 1 --- cystatin C --- vanin-1 --- microRNA --- uromodulin --- kidney graft function --- biomarker --- kidney transplantation --- long noncoding RNA --- rejection --- microvascular injury --- urinary aminopeptidases --- arterial hypertension --- renal function --- urinary biomarkers --- markers of AKI --- cystatin-C --- NGAL --- KIM-1 --- exercise --- end-stage kidney disease (ESKD) --- cardiovascular disease --- epidemiology --- CKD --- macrophage subpopulation --- renal fibrosis --- trichostatin A --- kidney graft --- T-cell-mediated rejection --- antibody-mediated rejection --- diagnostic test accuracy --- gentamicin --- sepsis --- miRNA --- nephrotoxicity --- vancomycin --- n/a
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