Most common species of pseudomonas associated with
intravascular catheter is Pseudomonas Aeruginosa.
Intravascular catheter related infections
Indwelling vascular catheters are a leading source of bloodstream
infections.
Amongst indwelling vascular catheters, central venous catheters are
the most common culprits.
Pathogenesis
There are four potential sources for catheter related infections ?
1) The skin insertion site
2) The catheter hub
3) Hematogenous seeding from a distant infection
4) Contaminated infusate
The skin insertion site and the catheter hub are by for the two most
important sources.
Approximately 65% of catheter related infections originate from the
skin flora, 30% from the contaminated hub and 5% from other pathways.
For short term catheters, skin contamination is the most likely
mechanism of pathogenesis.
On the other hand, for long term catheters, hub contamination is
more .
frequent because such catheters often have to be intercepted
and manipulated.
Skin organisms migrate from the skin insertion site along the
external surface of catheter, colonizing the distal intravascular tip of
the catheter, and ultimately causing blood-stream infection. On the
other hand, in hub related infections, organisms are usually
introduced into the hub from the hands of medical personnel and the
organisms migrate along the internal surface of the catheter, where
they can cause a bloodstream infection.
Microbiology
Most of the micro-organisms implicated in CRIs arise from the skin
flora.
Staphylococci are the most frequently isolated pathogens,
paricularly coagulase-negative staphylococci
Etiology of catheter related infection
Microorganism Percentage
• Coagulase negative
staphylococci
30 - 40
• Staph aureus 5 - 10
• Enterococci 4 - 6
• Candida spp. 3 - 6
• Pseudomonas
aeruginosa
2 - 5
• Enterobacter spp 1 - 4
• Acinetobacter spp. 1 - 2
• Serratia spp. <1
• Others < 1 - 5

Test : Vitamin B12/ Anti-pernicious anemia factor/ Cyanocobalamin




Indications : The test is used to detect Vitamin B12 deficiency as in pernicious anemia in those patients who have hematologic symptoms – weakness, anemia, hyper-segmented neutrophils, leucopenia, or Neurologic – numbness, tingling, loss of vibratory sensation.
Physiology : Cyanocobalamin analogues from the base compound in coenzymes having important biologic functions. Vitamin B12 is not synthesized by humans. It is a requisite dietary component widely available in animal products. The minimum daily requirement is 1-5 µg/day, body stores are 2000-5000 µg. Vitamin B12 is absorbed by microvilli of the ileum a pH and divalent cation dependent process.
Normal Range : 100-250 pg/mL (74-185 pmol/L)
Interpretation : Vitamin B12 is low in hypochlorhydria, pernicious anemia, intestinal absorption, inflammatory bowel disease, bacterial infection. Diphyllobothrium fish tapeworm, intestinal surgery, oral contraceptives, increase in red blood cell volume. Vitamin B12 is increased in chronic granulocytic leukemia, chronic renal failure, severe congestive heart failure, diabetes, obesity and liver cell damage.
Test Method: Radioimmunoassay (RIA)
Related Tests : Complete Blood Count, Folic Acid, Hemoglobin, Intrinsic Factor Antibody, Red Blood Cell Indices, Schilling Test
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Summary of Immune Thrombocytopenia (ITP)

Approach to Anemia

Approach to Hemolytic Anemia

📖 Reference: The Hospital for Sick Children, Handbook of Pediatric 18th edition

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📖 Reference: The Hospital for Sick Children, Handbook of Pediatric 18th edition

General Prognostic Factors in Acute Lymphoblastic Leukemia

📖 Reference: Nelson Essential of Pediatric, 8th Edition

Common Laboratory Finding in the Diffrantial Diagnosis of Microcytic Anemia