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Catheter associated infections in hemodialysis patients
Suzan Sanavi1, Ahad Ghods, Reza Afshar
1Iran University of Medical Science.
Insights
Hemodialysis catheter-related infections (HCRI) are a significant concern in hemodialysis patients. This study found no clear risk factors for HCRI, but noted low antibiotic resistance and longer catheter dwell times.
Area of Science:
- Nephrology
- Infectious Diseases
- Clinical Medicine
Background:
- Hemodialysis catheter-related infections (HCRI) are a major cause of morbidity, mortality, and increased healthcare costs in hemodialysis patients.
- Identifying predisposing risk factors is crucial for preventing HCRI.
Purpose of the Study:
- To determine the frequency of risk factors associated with hemodialysis catheter-related infections.
Main Methods:
- A study was conducted on 116 hemodialysis patients diagnosed with HCRI between 2003 and 2004.
- Data collected included patient demographics, medical history, causative organisms, antibiotic resistance, and catheter-related parameters.
- Statistical analysis was performed to identify associations between various factors and HCRI.
Main Results:
- No significant statistical association was found between HCRI and factors such as age, gender, diabetes, serum albumin, leukocyte count, ESR, catheter location, antibiotic therapy duration, catheter duration, dialysis frequency, or previous infection history.
- The most common pathogens were Staphylococcus aureus (42%) and Coagulase-negative Staphylococci (20%).
- Bacterial resistance to vancomycin and amikacin was low (7% and 4%, respectively).
- The mean duration of catheter usage was longer than previously reported.
- HCRI accounted for 67% of all blood-borne infections in the hospital during the study period.
Conclusions:
- The prevalence of common HCRI pathogens aligns with previous research.
- Low bacterial resistance to tested antibiotics was observed.
- Longer mean catheter dwell times may be a factor, warranting further investigation.
Abstract:
Hemodialysis catheter related infections (HCRI) are one of the major causes of increasing mortality, morbidity and cost of therapy in hemodialysis patients. Prevention of HCRI requires the identification of predisposing risk factors. To determine the frequency of HCRI risk factors, we studied 116 patients (54% male, mean age of 49.5+/-16 years) patients with HCRI between 2003-2004. Forty one percent of the patients were diabetic. There was a history of previous catheter placement and infection in 41% and 32% of patients, respectively. Pathogenic organisms isolated from blood cultures included Staphylococcus-aureus 42%, Coagulase-negative Staphylococci 20%, E. Coli 19%, Enterococci 7%, Streptococcus D 7%, Pseudomonas aeruginosa 4%, and Klebsiella 1%. Bacterial resistance to vancomycin and amikacin was present in 7% and 4% of the cases, respectively. Hemodialysis catheter related blood borne infections comprised 67% of the total blood-borne infections in our hospital. No significant statistical association was found between HCRI and age, gender, diabetes mellitus, serum albumin level <30 g/L, leukocyte count, erythrocyte sedimentation rate, anatomical location of catheter, mean duration of antibiotic therapy, mean catheter duration, frequency of hemodialysis sessions, pathogenic organisms, and history of previous catheter infection. We conclude that the prevalence of pathogenic organisms of HCRI were similar to previous studies. However, bacterial resistance to antibiotics was low. The mean duration of catheter usage was longer than previously reported.
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