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Gram-negative bacteraemia in haemodialysis
Eleanor C Murray1, Aleksandra Marek2, Peter C Thomson1
1Renal Unit, Western Infirmary, Glasgow, UK.
Summary
Gram-negative bacteraemia is a serious risk for haemodialysis patients, often originating from central venous catheters or infected ulcers. Despite antibiotic sensitivity, mortality remains high, necessitating careful vascular access planning and aggressive treatment.
Area of Science:
- Nephrology
- Infectious Diseases
- Public Health
Background:
- Patients on renal replacement therapy face elevated morbidity and mortality risks.
- Infection is the second leading cause of death in this population.
- This study investigates Gram-negative bacteraemia in haemodialysis patients.
Purpose of the Study:
- To identify pathogens, sensitivity patterns, infection sources, and outcomes of Gram-negative bacteraemia.
- To analyze risk factors associated with Gram-negative bacteraemia in haemodialysis patients.
- To inform strategies for preventing and managing bacteraemia in renal replacement therapy.
Main Methods:
- Retrospective data collection from July 2011 to April 2014.
- Analysis of electronic patient records from NHS Greater Glasgow & Clyde and NHS Forth Valley haemodialysis populations.
- Confirmation of data through independent Microbiology database searches.
Main Results:
- A total of 95 Gram-negative bacteraemia events occurred over 544,377 haemodialysis days.
- Central venous catheters (CVCs) and infected ulcers were the most common sources.
- Escherichia coli was the predominant pathogen; high sensitivity to meropenem was observed.
Conclusions:
- Central venous catheters and diabetic foot ulcers are significant risk factors for Gram-negative bacteraemia.
- Early mortality following Gram-negative bacteraemia remains high, underscoring the need for aggressive treatment.
- Vascular access planning is crucial for mitigating bacteraemia risks in haemodialysis patients.
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