Tunneled catheters' outcome optimization among diabetics on dialysis through antibiotic-lock placement

Efficacy and safety of antibiotic ‘locks’, in prevention of thrombotic and infectious complication-related morbidity and mortality, among diabetics dialyzed through tunneled-cuffed catheters (TCCs) has not been effectively investigated. This trial was designed to investigate the outcome of TCCs (n=109), inserted among 96 diabetic end-stage renal disease patients (March 2002–February 2003), by comparing the catheter thrombosis, catheter-related bloodstream infections (CRBSI), catheter survival, and mortality rates, between the cohorts of 49 patients who had TCCs (n=51) ‘locked’ with cefotaxime/heparin (group I) and 47 patients with TCCs (n=58) filled with standard heparin (group II). Thrombosis was defined as the inability to use catheter at a blood flow of 200ml/min despite intraluminal thrombolysis. Primary end points were catheter thrombosis and CRBSI; elective catheter removal and CRBSI-related death led to sensor of TCCs follow-up. Patients with intraluminal cefotaxime/heparin lock, on cumulative survival analysis, showed a superior thrombosis-free (86.3 vs 63.8%, P=0.023, log rank), infection-free (72.9 vs 27.1%, P=0.004, log rank), and thrombosis- and infection-free TCC survival (78.4 vs 37.9%, P=0.001, log rank) at 365 days, besides having significantly lower incidence of CRBSI (1.56 vs 3.68 episodes/1000 catheter days, P<0.0001) and CRBSI-related mortality (9.8 vs 23.4%, P=0.015), compared with the heparin-alone group. Deployment of cefotaxime–heparin ‘lock’ enhances catheter survival; reduces thrombotic and infectious complications and ensuing mortality, among diabetics on dialysis. However, further studies are needed to define the long-term implications of antibiotic locks in terms of the risk of emergence of antimicrobial resistance

Detecção de Salmonella Anatum em ema (Rhea americana) Detection of Salmonella Anatum in the Greater Rhea (Rhea americana)

Para pesquisa de Salmonella spp. foram coletadas amostras de fígado e conteúdo cecal de 70 emas (Rhea americana) abatidas no Rio Grande do Sul - Brasil. Uma colônia morfológica e bioquimicamente compatível com Salmonella spp., isolada de uma amostra de fígado, foi sorotipada como Salmonella Anatum. Considerando-se o alto potencial zoonótico deste microrganismo, destaca-se a relevância do controle microbiológico efetivo em frigoríficos que abatem espécies silvestres, assim como no produto final.<br>In aiming to investigate the Salmonella spp. presence in one slaughterhouse in Rio Grande do Sul - Brazil, liver and cecum samples from 70 Greater Rhea (Rhea americana) were collected. One Salmonella-like colonie was serologically typed and identified as Salmonella Anatum. Considering the high zoonotical potential of this microorganism, an effective microbiological control of wild animal slaughterhouses and the final product is needed