Herapy is essential in the management of those individuals. You’ll find few information about septic shock etiology in kidney transplant recipients. Objectives: The aim of this study is PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20725854 to decide probably the most widespread septic shock etiologic agents in kidney transplant recipients. Setting: A kidney transplant specialized ICU within a 90-bed public hospital. Strategies: We prospectively followed (from Could 2000 to December 2001) kidney transplant recipients admitted to ICU with diagnosis of septic shock according to SCCM/ACCP criteria. ICU resource utilization, microbiological identification and 28-day mortality have been recorded. Apache II score for every patient was calculated inside 24 hours of admission. Results: We studied 14 (10 M/4 F) consecutive patients admitted to ICU with septic shock diagnosis. The mean age was 43 ?9.5 years and mean Apache II was 23.7 ?7.three. All individuals had been receiv-Available on-line http://ccforum.com/supplements/6/Sing immunosuppression therapy at ICU admission and 11 (78,five ) had been inside the very first year of transplantation. The sources of infection have been: lungs (n = six), intra-abdominal (n = four), endocarditis (n = 2), central venous catheter (n = 1) and central nervous system (n = 1). Essentially the most popular isolated microorganisms have been: Candida (n = 5), cytomegalovirus (n = 4), Staphylococcus aureus (n = 3), Acinetobacter baumanii (n = two), Escherichia coli (n = 2), Pneumocystis carinii (n = 2), Klebsiella (n = 1) and Mycobacterium tuberculosis (n = 1). In only 3 (21 ) patients just one agent was isolated and in a further three (21 ) individuals we had been not in a position to recognize the etiologic agent. The mean length of ICU stay was 15 ?15.days and of mechanical ventilation was 12.5 ?16 days. In 10 (71 ) of these patients a pulmonary artery catheter was inserted and there was need to have for renal replacement therapy in 13 (93 ) individuals. The 28-day mortality was 71 and all round ICU mortality was 78.five .Conclusions: Although kidney transplant recipients are susceptible to opportunistic infections because of immunosuppressive therapy, bacteria remain a frequent septic shock etiologic agent in these sufferers.PColistin within the therapy of infections from multiresistant Gram (? bacilliN Markou*, P Malamos*, D Hroni*, I Alamanos*, A Damianos, H Apostolakos* *ICU-B, KAT Hospital, Athens, Greece; Division of Pulmonary Medicine, Hospital `A Fleming’, Athens, Greece Objective: To present our expertise with i.v. colistin within the remedy of infections with multiresistant Gram (? bacilli. Materials and strategies: Fourteen sufferers aged 20?1 years old, with serious infection from multiresistant Gram (? bacilli, sensitive only to colistin. From the sufferers, 11 were critically ill and mechanically ventilated, with an APACHE II score 8?two, and also the other 3 had been non-intubated individuals with acute respiratory failure, treated inside the ward. All individuals received intravenous colistin (150,000 U/kg i.v., adjusted for creatinine clearance). A second antibiotic (in 11 circumstances high-dose b-lactam in continuous intravenous infusion) was added within the regimen. In total 16 courses of i.v. colistin have been provided, for the following infections: ventilator-associated pneumonia (VAP) (nine instances), nosocomial pneumonia in non-intubated sufferers (three), sepsis of unknown primary origin (one particular), urosepsis (one), GDC-0077 site catheter-related sepsis (two). In all circumstances, in spite of documented resistance, was incorporated in the therapeutic regimen. The bacteria accountable were P. Aeruginosa (14 circumstances) or Acinetobacter baumanii (two.