So, this time, it’s our old friend enterococcus plus acinetobacter. According to the CDC, “Outbreaks of Acinetobacter infections typically occur in intensive care units and healthcare settings housing very ill patients. Acinetobacter infections rarely occur outside of healthcare settings.” It’s another one of those that’s resistant to a lot of things. Happily, Teddy’s enterococcus is susceptible to one of the cillins and the acinetobacter is susceptible to one of the cephalosporins. He’s had negative cultures since Friday, and we’re hoping to hear from surgery today re: scheduling that catheter replacement.
Conclusion: Teddy needs to spend less time in the hospital.
The Renal Fellow Network blog recently had a post about buried catheters. Evidently, some hospitals, when they insert a new PD catheter, leave the external portion of the catheter buried inside the patient. When it’s ready to be used, they make a small incision in the office and pull it out. Since it’s buried, the catheter and the tunnel are less likely to get colonized with bacteria, and they’ve found that this procedure reduces the incidence rate of peritonitis and tunnel infections. Interesting, eh? Of course, this is on ADULT patients… I don’t know where one would begin to bury the external portion of a catheter on Mr T.
But this is what I found most interesting: “The period prior to externalization varied between 2 and 788 days with an average of 40 days. There was no relationship between catheter embedment time and the risk of catheter failure. 90% of catheters worked immediately and of the remaining 13 catheters, 12 were easily corrected laparascopically.” Geez. Wish that would hold true for us.