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K Kowalewska-Grochowska

Publications and source records attributed to K Kowalewska-Grochowska.

6 recordsLinked to original sources
PubMed1998

Central venous catheters as a source of hemodialysis-related bacteremia.

OBJECTIVE: To describe investigations into an increase in hemodialysis-related bacteremia that occurred in our hospital in the first 6 months of 1996. SETTING: Hemodialysis unit in a tertiary-care medical center. METHODS: Prospective surveillance for hemodialysis bacteremia has been performed for several years. Cases that occurred in 1995 were compared to cases in the first 6 months of 1996. Unit data on dialysis runs and method of dialysis access were used to calculate rates. Nested polymerase chain reaction (PCR) was used to type 18 Staphylococcus aureus isolates from 1996. A case-control study comparing 80 randomly selected hemodialysis patients from 1995 and 1996 was performed to examine infection risk factors. RESULTS: The hemodialysis bacteremia rate was 1.2 per 1,000 runs in 1995 and 2.8 per 1,000 in the first 6 months of 1996 (P=.0009). The 25 cases in 1995 and 32 in the first half of 1996 were similar in age, gender, means of vascular access, and microbial etiology. Central venous catheter (CVC) access accounted for >90% of cases in both time periods. S aureus was the most common microbial etiology (53% of the 1996 cases). PCR typing of S aureus isolates from 1996 demonstrated five different strains, the most common having six isolates. The use of CVCs as a means of vascular access abruptly increased in the unit in January 1996, from <30% of dialysis runs in 1995 to >40% in 1996 (P<.001), associated with structural changes in healthcare delivery in the region resulting in delays in performing surgical procedures, such as creation of vascular grafts and fistulae. CONCLUSION: A marked increase in hemodialysis bacteremia occurred in 1996, associated with increased reliance on CVCs for vascular access in hemodialysis patients during a period of healthcare restructuring.

Adult↗
PubMed1992

Hansenula anomala fungemia in an infant with gastric and cardiac complications with a review of the literature.

A 6-month-old female infant, with a birth weight of 2.74 kilograms, was born with multiple congenital abnormalities, including gastric and gastrointestinal defects. She was admitted to the hospital with hematemesis. The patient could not be fed orally, and parenteral nutrition was initiated through a central venous catheter. Following pyloroplasty, she developed superior vena cava syndrome, renal disfunction and episodes of sepsis. Stool and respiratory specimens were negative for fungi, but four blood cultures yielded Hansenula anomala var. anomala. Cultures for fungi from intravenous catheter tips were negative. The baby was treated with amphotericin B (am B) and 5-fluorocytosine (5-FC), (amB; 0.1 mg/kg body weight and 5-FC, 100 mg, q.i.d.). The minimal inhibitory concentrations of am B, 5-FC, am B + 5-FC (1:1, w:w) and fluconazole to H. anomala were 1.56, less than 0.195, 1.56, and 1.56 micrograms, respectively. Following antifungal therapy and removal of the catheter, the patient tolerated oral feeding and, at the time of discharge, her weight had increased to 4.91 kg. This report records H. anomala as an opportunistic yeast pathogen for the first time in Alberta, Canada. Previously published cases of H. anomala infections are reviewed.

Abnormalities, Multiple↗
PubMed1991

Guidewire catheter change in central venous catheter biofilm formation in a burn population.

This study was designed to assess the risk of colonization and biofilm formation of central venous catheters left in situ for seven days vs those changed over a guidewire at three days and removed at seven days. Colonization was determined using scanning and transmission electron microscopy and compared to a special scraping/sonication culture method. Thirty-one catheters were examined, and no difference was found between catheters left in situ (9 of 16 colonized) and those changed over a guidewire (11 of 15 colonized). Colonization rates rose significantly from 4 of 15 catheters at the time of guidewire change to 11 of 15 at 7 days (p less than 0.001). Of the catheters defined as colonized by SEM, the special culture technique showed bacterial growth in only 35 percent, making a negative culture result of dubious value in ruling out catheter colonization. No beneficial effect of guidewire changes in reducing colonization could be demonstrated.

Bacterial Adhesion↗
PubMed1991

Catheter biofilms and recurrent CAPD peritonitis.

To study the significance of biofilm bacteria in CAPD peritonitis, in a preliminary study, we compared the growth of planktonic and biofilm bacteria by parallel cultures of the same PD effluent in 14 patients with CAPD-associated peritonitis. Planktonic bacteria were isolated by routine microbiologic culture techniques and biofilm bacteria by the use of a modified Robbins' device (MRD). Antibiotic sensitivity or MIC's of bacterial strains isolated by the two techniques were compared. This comparison of the IC identified a subgroup of patients who developed recurrent antibiotic resistant biofilm-induced peritonitis and their peritoneal catheters were subsequently removed.

Adult↗
PubMed1988

Biliary ascariasis.

We report biliary lithiasis secondary to infestation with Ascaris lumbricoides in a young man. We review the pathogenesis and clinical features of this condition and discuss the differential diagnosis.

Adult↗