Acute kidney injury (AKI) is a frequent complication in patients with Staphylococcus aureus bacteremia (SAB), with a significant impact on patient management and outcome. This study aimed to... Show moreAcute kidney injury (AKI) is a frequent complication in patients with Staphylococcus aureus bacteremia (SAB), with a significant impact on patient management and outcome. This study aimed to provide insight in the proportion of patients with SAB that develop AKI, the risk factors for developing AKI in this population, and its reversibility. In this retrospective, multicenter cohort study, adult patients with SAB were eligible for inclusion. Patient characteristics, clinical variables, and laboratory results were retrieved from the electronic patient files. Primary outcome was development of AKI, defined as 1.5 times baseline creatinine. Secondary outcomes were reversibility of AKI and risk factors for AKI. A total of 315 patients with SAB were included, of whom 115/315 (37%) developed acute kidney injury. In 68/115 (59%), the AKI was reversible. If kidney function recovered, this occurred within 7 days in 56/68 (82%) of patients. In multivariable logistic regression analyses, independent risk factors for AKI were as follows: complicated SAB, use of diuretics, and hemodynamic instability. Development of AKI was associated with 30-day mortality (OR 3.9; CI 2.2-6.9; p < 0.01). Acute kidney injury is a frequent complication in patients with Staphylococcus aureus bacteremia. Considering the irreversibility in a relevant proportion of patients, future research into the underlying pathophysiology and potential interventions is warranted. Show less
Kachrimanidou, M.; Protonotariou, E.; Kaiafa, G.; Ztrieva, E.; Skoura, L.; Savopoulos, C.; Kuijper, E. 2020
Clostridioides difficile is the leading cause of healthcare-associated diarrhea. Although the incidence of C. difficile-associated diarrhea is increasing worldwide, bacteremia due to C. difficile... Show moreClostridioides difficile is the leading cause of healthcare-associated diarrhea. Although the incidence of C. difficile-associated diarrhea is increasing worldwide, bacteremia due to C. difficile is relatively rare and represents the least frequent extra-colonic manifestation of C. difficile infection.To date, only 60 C. difficile bacteremia cases with detailed clinical patient characteristics have been reported in the literature, and another 77 cases have been identified in epidemiological reports. We report a rare and fatal case of bacteremia due to C. difficile from a Greek hospital. (C) 2020 Elsevier Ltd. All rights reserved. Show less
Dit proefschrift behandeld allerlei klinische vragen waarmee de arts geconfronteerd wordt als een volwassene zich presenteert met een gecompliceerde urineweginfectie. In verschillende hoofdstukken... Show moreDit proefschrift behandeld allerlei klinische vragen waarmee de arts geconfronteerd wordt als een volwassene zich presenteert met een gecompliceerde urineweginfectie. In verschillende hoofdstukken wordt ingegaan op de volgende vragen: Wanneer moet de pati_nt worden opgenomen? Wanneer dient rekening te worden gehouden met een resistent oorzakelijk micro-organisme? Wanneer is radiologisch onderzoek van de urinewegen nuttig? Wanneer heeft een bloedkweek toegevoegde waarde naast een urinekweek? Hoe lang dient te worden behandeld met antibiotica? Daarnaast wordt de relatie tussen urineweginfecties en de functie van de bekkenbodem beschreven. Show less
