title: Screening for bacteremia in sepsis and renal failure using hemofilters for renal replacement therapy.
abstract: BACKGROUND
  In patients with sepsis and renal failure, extracorporeal blood flow during renal replacement therapy may lead to the deposition of bacteria on artificial membranous surfaces, which might be suitable for the detection of pathogens. We studied whether discarded dialysis hemofilters can be used for the detection of bacteremia in patients with sepsis and renal failure.
  
  
  METHODS
  Hemofilters of 16 ICU patients with sepsis were sampled. The hemofilters were incubated with soy broth and dehisced under sterile conditions. Samples were plated on blood agar and analyzed. Patient's characteristics were assessed.
  
  
  RESULTS
  Despite the use of antibiotics in 87.5 % (14/16), a true positive detection rate of 31.3 % (5/16) for bacteremia was found by using cultures from hemofilters. The overall true positive rate of blood cultures was significantly lower (10.7 %, 8/75, p = 0.048). Bacteria detected in hemofilters were similar to those found in blood cultures or by cultures from other sources of infection in 80 % (4/5).
  
  
  CONCLUSIONS
  Cultures from used hemofilters of patients with sepsis and renal failure provide the opportunity to identify pathogenic microorganisms as an add-on approach. Further studies should investigate whether this method is applicable in clinical practice to enhance the sensitivity of microbiological diagnostics.
authors.affiliation: Clinic for Anesthesiology and Intensive Care, Jena University Hospital, Erlanger Allee 101, 07747, Jena, Germany. gordon.otto@med.uni-jena.de
authors.forename: G P
authors.initials: GP
authors.lastname: Otto
authors.forename: M
authors.initials: M
authors.lastname: Kropf
authors.forename: M
authors.initials: M
authors.lastname: Sossdorf
authors.forename: P
authors.initials: P
authors.lastname: Recknagel
authors.forename: W
authors.initials: W
authors.lastname: Lösche
authors.forename: J
authors.initials: J
authors.lastname: Rödel
authors.forename: R A
authors.initials: RA
authors.lastname: Claus
authors.forename: M
authors.initials: M
authors.lastname: Busch
mesh_terms: D016470:Bacteremia / Q000175:diagnosis*; D001431:Bacteriological Techniques; D016983:Enterococcus / Q000302:isolation & purification; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000382:microbiology; D006440:Hemofiltration / Q000295:instrumentation*; D006801:Humans; D007362:Intensive Care Units; D008567:Membranes, Artificial; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000473:pathology*; D017582:Renal Replacement Therapy / Q000379:methods*; D015203:Reproducibility of Results; D018805:Sepsis / Q000382:microbiology / Q000473:pathology*; D013210:Staphylococcus / Q000302:isolation & purification
chemical_list: D008567:Membranes, Artificial