HE PATOLOGY
patient – could reduce cravings for alcohol as the first step for use in subsequent larger trials. In a pilot, double-blind, placebo- controlled, randomised clinical trial, 20 patients with alcohol use disorder (AUD) and liver cirrhosis, who had tried several options to quit alcohol unsuccessfully, were given FMT or placebo, with FMT shown to reduce alcohol cravings as well as total and psychosocial sickness impact profile at Day 15 post-treatment.
A corresponding significant increase in microbiota diversity was seen in FMT patients compared with baseline (p=0.02), including a higher relative abundance of Odoribacter. Alistipes and Roseburia were also more abundant in patients given FMT compared with placebo at Day 15. “FMT was safe and shown to have an impact on reducing short-term alcohol cravings and improving psychosocial quality of life in patients with cirrhosis and AUD,” added study presenter Dr. Jasmohan S Bajaj, of McGuire VA Medical Center, US. “The relative abundance of short-chain fatty acid-producing bacteria identified in patients with higher diversity after FMT demonstrates that altering the gut–brain axis is a potential avenue to alleviating AUD in those with cirrhosis.”
A second study explored how gut microbiota may affect the process of developing hepatocellular carcinoma, using mice that have been genetically engineered to develop steatohepatitis. By crossing these mice with others that have had other genes involved in the inflammatory response to bacteria inactivated, and then altering the gut microbial balance with broad-spectrum antibiotics, the research team showed that knocking out the NLRP6 receptor (a key mediator of colonic homeostasis that can cause intestinal dysbiosis if deficient) leads to more severe steatohepatitis and a higher tumour burden.
Reducing mortality
The conference also provided important insights into reducing liver transplant waiting-list mortality. Prioritising patients for liver transplantation using the Model for End-stage Liver Disease Sodium (MELD-Na) score, instead of the more commonly used MELD score, could increase the chances of high-risk patients receiving a transplant and reduce the risk of dying while on the waiting list, according the results of a large study using data from the Euro transplant network. Researchers from Leiden University Medical Centre in the Netherlands evaluated more than 5,000 patients with chronic liver disease who had been allocated to the Euro transplant liver waiting list using the MELD score, and found that more than one-quarter of those who died within three months of being listed might have received a transplant if the MELD-Na score had been used
instead. The MELD score, which estimates mortality risk for patients with end-stage liver disease using laboratory variables, has been used to prioritise patients on liver transplant lists for almost 20 years. Although MELD has been very successful in prioritising patients, it does not accurately reflect the risk of death in patients with hyponatremia (low sodium levels), which is an important predictor of mortality in patients on liver transplant lists. The MELD-Na score, which includes serum sodium in the risk calculation, was adopted in the United States in 2016 for liver transplant prioritisation but is not yet used routinely across Europe. To test whether the use of the MELD-Na score in the Euro transplant region (which includes Austria, Belgium, Croatia, Germany, Hungary, Luxembourg, the Netherlands, and Slovenia) could improve outcomes, the Leiden team evaluated 5,223 patients who
Blood Cultures. Shouldn't ZERO contaminants now be the target?
Blood Cultures. Shouldn't ZERO contaminants now be the target?
Blood Cultures. Shouldn't ZERO contaminants now be the target?
Blood Culture Collection Sets
The Kurin Lock® with Flash Technology automatically sidelines the initial flash of blood which may contain skin contaminants. Roughly 20% of the microbes present in skin reside deep in the dermis¹. During venipuncture, contaminants can be drawn into blood culture samples leading to high rates of seemingly unavoidable false positive blood cultures.
Reducing False Positives Blood Cultures will;
Improve accuracy of blood culture test results. Reduce unnecessary antibiotic prescribing and usage.
Reduce length of stay for patients, associated risk of HAI's and excessive costs.
. Hospitals spend £2,000 - £12,00022 per false positive result prevented.
The degree of intestinal barrier permeability was highly correlated with tumour burden as well as several indicators of inflammation in the liver. Crucially, this immune phenotype could be transferred to other mice by FMT, provided they had functional TLR4 signalling, and could be reversed if the transplanted microbiota were depleted with broad-spectrum antibiotics. “Strikingly, we also found that replacing depleted Akkermansia muciniphila bacteria in the guts of these mice helped ameliorate their inflammation and steatohepatitis,” said Dr. Kai Markus Schneider of University Hospital RWTH Aachen, Germany. “This knowledge of how short-term changes to microbiota reshape the hepatic tumour microenvironment has the potential to reveal new therapeutic options for cancer prevention and therapy.”
ISK/KUR/161020/SJM/V1 NOVEMBER 2020
Deliver significant reduction in the economic burden; £2,000-£12,0002
with significant cost savings. Blood Culture Collection Sets
The Kurin Lock® with Flash Technology sidelines contaminants in the initial flash of blood which may contain skin contaminants. Roughly 20% of the microbes present in skin reside deep in the dermis¹, with venipuncture, contaminants can be dislodged and drawn into blood culture samples leading to high rates of seemingly unavoidable false positive blood cultures.
Why Use It? Approximately 1/3 of all positive blood cultures are false positive results due to blood culture contamination1
per false positive test that
When Kurin was used, even hospitals below the 3% benchmark reduced blood culture contamination rates by up to 90%3
1. Garcia RA et al. Am J Infect Control. 2015 Nov 1; 43(11): 1222-37. 2. Alahmadi YM et al. Journal of Hospital Infection 2011; 77:233-6 3. Sutton J et al. Professionals in Infection Control, June 13-15, 2018 Minneapolis, MN [Abstract: EI – 101] Poster.
When Kurin was used, even hospitals below the 3% benchmark reduced blood culture contamination rates by up to 90%3with significant cost savings.
How does it work? Each Kurin blood culture collection set features Kurin Lock®, an elegantly simple, an intuitive design that requires no additional user steps. Kurin is a passive device that automatically sidelines potential contaminants during blood culture collection.
Serves as a flash chamber to provide visual confirmation of proper needle placement in the vein.
Contaminants residing in the initial ~0.15ml of blood are sidelined in the U-shaped side channel.
References.
1.Garcia RA et al. Am J Infect Control. 2015 Nov 1; 43(11): 1222-37.
2.Alahmadi YM, et al. (2011) “Clinical and economic impact of contaminated blood cultures within the hospital setting”. J Hosp Infect. 2011;77(3):233-236.
3.Sutton, J et al. Poster Pres. Association for Professionals in Infection Control, June 13-15, 2018 Minneapolis, MN [Abstract: EI – 101]
UKTel: +44 (0) 208 869 6509 IRL Tel: +353 (0) 1 428 7895 Email:
uksales@iskushealth.com
www.iskushealth.com
UKTel: +44 (0) 208 869 6509 IRL Tel: +353 (0) 1 428 7895 Email:
uksales@iskushealth.com
www.iskushealth.com ISK/KUR/161020/SJM/V1
leads to unnecessary treatment of non-existent bloodstream infections. Extended hospital stays increase the risk of hospital-acquired infections and adverse events and unnecessary antibiotics hamper efforts to improve antibiotic stewardship. The excess costs of these can run into hundreds or thousands of £. Kurin has been proven to reduce false positive rates by up to 90%3.
How does it work? Each Kurin blood culture collection set features Kurin Lock®, a small but powerful specimen diversion device that automatically sidelines the initial flash of blood during the routine process of drawing blood for culture.
1. Garcia RA et al. Am J Infect Control. 2015 Nov 1; 43(11): 1222-37. 2. Alahmadi YM et al. Journal of Hospital Infection 2011; 77:233-6 3. Sutton J et al. Professionals in Infection Control, June 13-15, 2018 Minneapolis, MN [Abstract: EI – 101] Poster.
Serves as a flash chamber to provide visual confirmation of proper needle placement in the vein.
Contaminants residing in the initial ~0.15ml volume of blood (35x a standard 21G needle) are sidelined in the U-shaped side
When the collection bottle is attached, blood flows into the culture bottle.
When the collection bottle is attached, blood flows from the vein into the culture bottle through the sampling channel.
WWW.CLINICALSERVICESJOURNAL.COM l
49
▲
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100
