Clinical impact of bacterial contamination of perfusion fluid in kidney transplantation.

Contamination of perfusion fluid (PF) could lead to serious infections in kidney transplant recipients. Preemptive therapy (PE-T) in case of yeast contamination of PF is mandatory. The usefulness of PE-T in presence of bacteria remains unclear. In this study we evaluated the incidence of PF bacterial contamination and the impact of PE-T on clinical outcome. Microbiological data of 290 PF and clinical data of the corresponding recipients collected in our hospital from January 2010 and December 2012 were analyzed. Recipients with bacterial contaminated PF (101) were divided in 3 groups: group 1 (n = 52) PE-T treated bacteria resistant to perioperative antibiotic prophylaxis (PAP), group 2 (n = 28) bacteria sensitive to PAP, group 3 (n = 21) PE-T-untreated bacteria resistant to PAP. Incidence of positive PF was 34.8 %, 50.4 % staphylococci, 9.9 % C. albicans. No significant differences in the rate of PF-related infections between the three groups were found. In conclusion, although PF contamination is frequent, the incidence of PF-related infections is very low. In addition, in this study PE-T did not help to reduce the rate of PF-related infection suggesting that a resonable reduction in the use of antibiotic terapy could be made. However, waiting for largest and prospective clinical trials to confirm our findings, a closely clinical and microbiologic monitoring of the recipient is highly recommended in case of PF contamination.

Cat-Scratch Disease: Case Report and Review of the Literature.

Cat-scratch disease (CSD) is caused by Bartonella henselae and characterized by self-limited fever and granulomatous lymphadenopathy. In some cases signs of a visceral, neurologic, and ocular involvement can also be encountered. In this report we describe the development of CSD in a kidney transplant patient. Immunocompromised hosts are more susceptible to infection from Bartonella compared with the standard population. Infection of Bartonella should be considered as a differential diagnosis in kidney transplant patients with lymphadenopathy of unknown origin.

Rapid detection of infectious mononucleosis-associated heterophile antibodies by a novel immunochromatographic assay and a latex agglutination test.

A novel immunochromatographic assay, the CARDS O.S. MONO test (Pacific Biotech, San Diego, Calif.), and a latex agglutination test, the Infectious Mononucleosis Kit (Unipath Ltd., Hampshire, United Kingdom) were compared with the Paul-Bunnell-Davidsohn test. Of the 957 serum specimens studied, 78 were positive and 879 were negative by the Paul-Bunnell-Davidsohn test. After discrepancies were resolved by determining Epstein-Barr virus serology, the sensitivities of the CARDS O.S. MONO test and the Infectious Mononucleosis Kit were 91.0 and 96.2%, respectively, and both tests had a specificity and a positive predictive value of 100% and a negative predictive value and overall agreement of greater than 99%. The results show that both tests can accurately detect infectious mononucleosis-associated heterophile antibodies.