Pathogenicity and virulence of the present hantaviruses in Bosnia and Herzegovina: the impact on renal function.

Dobrava (DOBV) and Puumala (PUUV) viruses are endemic throughout the Balkans and cause haemorrhagic fever with renal syndrome (HFRS). The aim of this study was to assess the impact of two different hantaviruses on renal function in HFRS patients during the acute stage of illness. We also aimed to assess the DOBV and PUUV distribution between symptomatic HFRS patients and asymptomatic hantavirus antibody-positive subjects. The study included 264 symptomatic HFRS patients and 63 asymptomatic hantavirus antibody-positive healthy subjects. In our study, 131 (49.6%) HFRS patients were regarded as PUUV- and 69 (26.1%) as DOBV-infected patients, while in 64 (24.2%) of HFRS patients that showed all clinical and biochemical signs of HFRS, the causal hantavirus could not be determined with commercially available tests. DOBV-infected patients were associated with more requirements for haemodialysis treatment, lower diuresis and higher serum creatinine and urea values compared to PUUV-infected patients. PUUV was significantly predominant in asymptomatic hantavirus antibody-positive subjects (69.8%) compared to HFRS patients. DOBV was present in 17.5% of asymptomatic subjects and, interestingly, the preferential hantavirus serotype could not be determined in 12.7% of the asymptomatic antibody-positive subjects.

[Flow obstruction and infection associated with the two-lumen subclavian catheter]. / Opstrukcija protoka i infekcija privremenog dvoluminalnog subklavijskog katetera.

INTRODUCTION: The aim of this study was estimate correlation between catheter clotting and catheter-related injection in haemodialysis (HD) patients with temporary double lumen catheters (TDLC). METHODS: We analysed 128 TDLC where we had exact microbiological result from catheter tip. There were 107 patients, mean age 54.70 +/- 15.02 years (15.80); 52 (48.60%) male ad 55 (51.40%) female, which were on haemodialysis 1162.62 +/- 183,424 (6-7200) days. RESULTS: Major reasons for application TDLC were acute HD in 56 (43.75%), a function of A-V fistula in 40 (31.25%) patients, and a function of previous TDLC in 32 (25%) patients. The primary causes of chronic renal disease were diabetes mellitus in 34 (27%), pyelonephritis in 31 (24%), glomerulonephritis in 24 (19%), polycistic kidney disease in 14 (11%), nephropathia endemic in 10 (8%) and others disease in 15 (12%) of patients. The analysed TDLC remained in place for an average of 51.34 +/- 64.03 (range 2-518) days. In case of 92 (71.88%) we got positive microbiological result (Staphylococcus coagulasa negative 33%, Staphylococcus aureus 16%, Bacillus species 9%). In 38 of these catheters (41.30%) we diagnosed problems with blood flow. Totally, we had 50 TDLC with obstruction, but in 12 of them we did not have microbiological confirmation of infection. CONCLUSION: Catheter clotting is one of the important factors that increase risk for developing catheter-related infection.