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Surveillance of hemodialysis related infections: a prospective multicenter study

Imran Hasanoglu1, Rahmet Guner2, Suzan Sahin3

  • 1Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Yildirim Beyazit University School of Medicine, Bilkent, Ankara, Turkey. ihasanoglu@aybu.edu.tr.

Scientific Reports
|December 23, 2022
PubMed

Insights

This study tracked hemodialysis (HD) infections in Turkey, finding a 1.98 rate per 100 patient-months. Patient education and arteriovenous fistulas significantly reduced infection risks, highlighting the need for a national surveillance program.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Public Health Surveillance

Background:

  • Turkey lacks a surveillance system for hemodialysis (HD)-related infections.
  • Investigating infection rates and implementing a standardized surveillance system are crucial.

Purpose of the Study:

  • To determine the infection rate among HD outpatients in Turkey.
  • To implement the Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) surveillance system for dialysis events (DEs).

Main Methods:

  • A multicenter prospective surveillance study was conducted over two years (April 2016-April 2018).
  • Data from 9 centers were collected using the CDC NHSN dialysis event (DE) protocol.
  • 10,035 patient-months of data were analyzed, identifying 199 DEs.

Main Results:

  • The overall DE rate was 1.98 per 100 patient-months.
  • Tunneled catheters posed a 17.6 times higher risk of blood culture positivity compared to arteriovenous fistulas.
  • Patient education on vascular access care significantly lowered DE rates.
  • Staphylococcus aureus was the most common cause of infection in deceased patients.
  • DE outcomes included hospitalization (73%), vascular access loss (18.2%), and death (7.7%).

Conclusions:

  • This study established baseline HD-related infection rates in Turkey.
  • The CDC NHSN DE surveillance system is feasible for implementation, even in high-workload units.
  • The system can be adopted nationwide to monitor and reduce dialysis-associated infections.

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