{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T19:20:50Z","timestamp":1790536850898,"version":"4.1.0"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T00:00:00Z","timestamp":1719273600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T00:00:00Z","timestamp":1719273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>CKD patients on hemodialysis (HD) with <jats:italic>Staphylococcus aureus<\/jats:italic> (SA) bacteremia present high morbidity, mortality and increased risk of MRSA. Vancomycin is the antibiotic of choice in these cases, it has a narrow therapeutic margin and inadequate dosage generates a risk of toxicity, therefore, the recommendation is to dosage it through serum levels.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This is a retrospective cohort study in 3 hospitals of third level of complexity in the city of Medellin in which there were differences in the measurement and implementation of vancomycin25 dosage based on trough levels (VL) in patients with chronic kidney disease on hemodialysis (CKD- HD) with uncomplicated bacteremia based infection by <jats:italic>methilcillin-resistant Staphyloccocus aureus<\/jats:italic> (MRSA). The primary outcome was the composite of hospital mortality, clinical response (fever, hemodynamic instability and altered consciousness), complications associated with bacteremia, or bacteriological response failure (positive cultures at first week follow-up) at 7\u00a0days. The composite variables were analyzed individually as secondary outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The main unadjusted outcome (OR 1.3, CI 0.6 - 2.7) and adjusted for age, Charlson index, loading dose, initial dose, dosing frequency and MIC to vancomycin (OR 1.2, CI 0.5 - 2.7). Regarding adjusted secondary outcomes: clinical response (OR 1.4 CI 0.3 - 5.8), death (OR 1.3 CI 0.3 - 4.6) and complications (OR 0.9, CI 0.37 - 2.2).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>We conclude that the measurement of trough levels in patients with HD-CKD does not modify the composite outcome. The main limitation is the sample size and type of study, randomized control trials may be required to confirm the results presented.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-024-08984-z","type":"journal-article","created":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T13:05:22Z","timestamp":1719320722000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of Vancomycin trough levels monitoring on uncomplicated methilcillin-resistant Staphylococcus aureus bacteremia in chronic kidney disease on hemodialysis, retrospective cohort"],"prefix":"10.1186","volume":"24","author":[{"given":"Julian Felipe","family":"Ramirez-Osorio","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Esteban","family":"Velez-Hernandez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalia","family":"Fernandez-Casta\u00f1o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Felipe","family":"Rojas-Hernandez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Jaimes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,25]]},"reference":[{"key":"8984_CR1","unstructured":"Acu\u00f1a Merch\u00e1n L, Mar\u00eda TD, Valbuena Garc\u00eda AM, Soler LA, Valderrama F. 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Mortalidad por estafilococcemia: influencia de la resistencia a meticilina y lugar de adquisici\u00f3n de la infecci\u00f3n, en una cohorte de pacientes de Medell\u00edn, Colombia. Enfermedades Infecc y Microbiol. 2020;40(1):420.","journal-title":"Enfermedades Infecc y Microbiol"},{"issue":"1","key":"8984_CR4","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1111\/j.1525-139X.2010.00803.x","volume":"24","author":"SJ Vandecasteele","year":"2011","unstructured":"Vandecasteele SJ, De Vriese AS. Vancomycin Dosing in Patients on Intermittent Hemodialysis. Semin Dial. 2011;24(1):50\u20135.","journal-title":"Semin Dial"},{"issue":"11","key":"8984_CR5","doi-asserted-by":"publisher","first-page":"835","DOI":"10.1093\/ajhp\/zxaa036","volume":"77","author":"MJ Rybak","year":"2020","unstructured":"Rybak MJ, Le J, Lodise TP, Levine DP, Bradley JS, Liu C, et al. Therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus infections: a revised consensus guideline and review by the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatr. Am J Heal Pharm. 2020;77(11):835\u201363.","journal-title":"Am J Heal Pharm"},{"issue":"3","key":"8984_CR6","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1016\/S0891-5520(03)00065-5","volume":"17","author":"WA Craig","year":"2003","unstructured":"Craig WA. Basic pharmacodynamics of antibacterials with clinical applications to the use of \u03b2-lactams, glycopeptides, and linezolid. Infect Dis Clin North Am. 2003;17(3):479\u2013501.","journal-title":"Infect Dis Clin North Am"},{"issue":"5","key":"8984_CR7","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1592\/phco.31.5.441","volume":"31","author":"R Kullar","year":"2011","unstructured":"Kullar R, Leonard SN, Davis SL, Delgado G, Pogue JM, Wahby KA, et al. Validation of the effectiveness of a vancomycin nomogram in achieving target trough concentrations of 15\u201320 mg\/L suggested by the vancomycin consensus guidelines. Pharmacotherapy. 2011;31(5):441\u20138.","journal-title":"Pharmacotherapy"},{"issue":"7","key":"8984_CR8","first-page":"e2917","volume":"10","author":"KA Rambaran","year":"2018","unstructured":"Rambaran KA, Alzghari SK, Seifert CF. Evaluation of factors which influence mortality in gram-positive bacteremia in hemodialysis patients. Cureus. 2018;10(7):e2917.","journal-title":"Cureus."},{"issue":"4","key":"8984_CR9","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1093\/cid\/cis458","volume":"55","author":"SA Zelenitsky","year":"2012","unstructured":"Zelenitsky SA, Ariano RE, McCrae ML, Vercaigne LM. Initial vancomycin dosing protocol to achieve therapeutic serum concentrations in patients undergoing hemodialysis. 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The need for informed consent was waived by the Ethics committee of (Hospital Pablo Tob\u00f3n Uribe [<i>HPTU<\/i>], Hospital San Vicente Fundaci\u00f3n - Medell\u00edn [<i>HUSVF<\/i>], Hospital Alma Mater de Antioquia [<i>HAMA<\/i>]). Patients personal data were protected during data collection and analysis.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Non applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"634"}}