Bacterial Load Associated With Tunneled Dialysis Catheters in Symptom-Free Hemodialysis Patients

This study aimed to evaluate the rate of asymptomatic bacterial infection of tunneled dialysis catheters (TDCs) removed due to maturation of native arteriovenous fistula (nAVF) or catheter dysfunction in hemodialysis patients with no clinically apparent infection.

A total of 229 patients (43.2% [n = 99] female and 56.8% [n = 130] male), who underwent hemodialysis through a TDC, were included in this study. Tip cultures of TDCs removed in an operating room and under sterile conditions were collected. All patients were asymptomatic for catheter infection and had not received antibiotic therapy for the last month.

The median duration of catheterization was 80 days (min: 5, max: 2880). Bacterial growth was observed in a total of 62 (27.1%) patients. The most common microorganisms were Staphylococcus epidermidis and Staphylococcus aureus. The asymptomatic infection rate was highest in catheters placed through the right and left subclavian veins; however, this was not statistically significant due to the small number of patients. Placement and usage time of TDCs were found to be the most significant factors for bacterial growth in the catheter tip culture (P < .001).

Prolonged duration and use of the catheter is significant in terms of bacterial load. The use of TDC as vascular access in renal replacement therapy should be avoided as much as possible.