Infection associated with double lumen catheterization for temporary haemodialysis: experience of 168 cases

A total of 227 patients with renal failure requiring acute haemodialysis with placement of a total of 260 Medcorp double lumen catheters at National Taiwan University Hospital from July 1992 to July 1993 were reviewed. Among them, only 135 patients receiving a total of 168 catheter placements and a complete infectious work-up were selected for this study. The mean age of the patients was 55 years (range 15-89 years); 63 (46.7%) were male and 75 (53.3%) were female. The three major reasons for dialysis were chronic glomerular disease (CGN; 49%), diabetic nephropathy (13%) and nephritis associated with systemic lupus erythematosus (SLE; 11%). The catheters remained in place for an average of 27.8 days (9-73 days) and each catheter was used for an average of eight treatments (2-26). The reasons for catheter removal were classified as: availability of permanent vascular access (48%), recovery of renal function (10%), scheduled duration (30 days, not every case; 4%), expiration of patient (10%), suspicion of catheter-related infections (15%), and catheter thrombosis/occlusion (9%). Seven cases with local haematoma and one case of pneumothorax were also identified (total 5%). In total, a 21.4% catheter-related infection rate was observed and micro-organisms such as Staphylococcus aureus (33%), coagulase-negative staphylococci (36%) and Enterococcus (19%) were isolated. The cumulative probability of patients remaining free from catheter-related infections was about 75% by the end of the fourth week post-catheter insertion, and decreased to less than 50% near the end of the second month of persistent catheterization.(ABSTRACT TRUNCATED AT 250 WORDS)