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Polymicrobial bacteremia during long-term hemodialysis
L L Mulloy1, R J Caruana, J C Steele
1Department of Medicine, Medical College of Georgia, Augusta 30912.
Southern Medical Journal
|May 1, 1991
Summary
Long-term hemodialysis patients are at increased risk for polymicrobial bacteremia, often linked to vascular access devices. Prompt removal of devices and antibiotic treatment are crucial for recovery.
Area of Science:
- Nephrology
- Infectious Diseases
- Hospital Epidemiology
Background:
- Polymicrobial bacteremia presents a significant challenge in hospital settings.
- Patients undergoing long-term hemodialysis are a vulnerable population for infections.
Purpose of the Study:
- To investigate the occurrence and characteristics of polymicrobial bacteremia in hemodialysis patients.
- To identify risk factors and outcomes associated with these infections.
Main Methods:
- Review of hospital epidemiologic data over a 30-month period.
- Analysis of five cases of polymicrobial bacteremia on a nephrology inpatient service.
- Examination of patient history, including dialysis status and vascular access devices.
Main Results:
- Five cases of polymicrobial bacteremia were identified in long-term hemodialysis patients.
- Four out of five patients had indwelling silicone rubber vascular access devices.
- No obvious skin or visceral infection was noted in any patient.
- One patient died; four recovered after device removal and antibiotic therapy.
Conclusions:
- Long-term hemodialysis is associated with an increased risk of polymicrobial bacteremia.
- Indwelling vascular access devices may play a role in the pathogenesis of these infections.
- Empiric antibiotic therapy should consider the risk of polymicrobial bacteremia in hemodialysis patients.