Mortality of Dialysis Catheter-related Blood Stream Infections in Hemodialysis Patients in Bhumibol Adulyadej Hospital
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Abstract
Background: Hemodialysis patients commonly require catheters as dialysis access, but catheter-related bloodstream infection (CRBSI) is a significant complication that can impact morbidity and mortality. Limited data exist on CRBSI in Thailand. This study aims to determine the prevalence of mortality, risk factors, and complications of hemodialysis non-cuffed venous CRBSI in Bhumibol Adulyadej Hospital, Thailand.
Methods: This study is a retrospective study of patients diagnosed with hemodialysis non-cuffed venous CRBSI in Bhumibol Adulyadej Hospital between January 2013 and December 2018. Data were collected to identify complications of CRBSI, including death and its risk factors.
Results: 1173 patients who inserted non-cuffed venous catheters for hemodialysis were identified. Seventy-eight patients (6.65%) of those were diagnosed with CRBSI. The mean age was 60±14 years old. There were 40 males (51.3%). The most common causative pathogens were gram-positive bacteria (46 episodes; 58.9%), with Staphylococcus aureus at 23 episodes (29.5%). The death rate was 15.38%. The mean length of hospital stay was 32.3±17.22 days and 20.8±19.6 days in the non-survived and survived groups, respectively (p = 0.002). Infection with gram-negative organisms and septic shock were higher in the non-survived group (49.95% vs. 32.3%, p=0.039 and 83.3% vs. 15.2%, p = 0.042 in both outcomes). Duration of catheterization tended to correlate with mortality.
Conclusions: The prevalence of mortality associated with non-cuffed venous CRBSI among hemodialysis patients in Bhumibol Adulyadej Hospital was 15.38%. Mortality was associated with longer hospital stays, gram-negative organism infections, and septic shock but not with the site or duration of catheterization. However, larger studies are required.
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References
Miller LM, Clark E, Dipchand C, Hiremath S, Kappel J, Kiaii M, et al. Hemodialysis Tunneled Catheter-Related Infections. Can J Kidney Health Dis. 2016;3:2054358116669129.
Nguyen DB, Shugart A, Lines C, Shah AB, Edwards J, Pollock D, et al. National Healthcare Safety Network (NHSN) Dialysis Event Surveillance Report for 2014. Clin J Am Soc Nephrol. 2017 Jul 7;12(7):1139–46.
Soi V, Moore CL, Kumbar L, Yee J. Prevention of catheter-related bloodstream infections in patients on hemodialysis: challenges and management strategies. Int J Nephrol Renovasc Dis. 2016;9:95–103.
Saxena AK, Panhotra BR. Haemodialysis catheter-related bloodstream infections: current treatment options and strategies for prevention. Swiss Med Wkly. 2005 Mar 5;135(9–10):127–38.
Chang CF, Kuo BIT, Chen TL, Yang WC, Lee SD, Lin CC. Infective endocarditis in maintenance hemodialysis patients: fifteen years’ experience in one medical center. J Nephrol. 2004;17(2):228–35.
Sahli F, Feidjel R, Laalaoui R. Hemodialysis catheter-related infection: rates, risk factors and pathogens. J Infect Public Health. 2017;10(4):403–8.
Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O’Grady NP, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2009 Jul 1;49(1):1–45.
National Kidney Foundation. KDOQI Clinical Practice Guideline for Hemodialysis Adequacy: 2015 update. Am J Kidney Dis. 2015 Nov;66(5):884–930.
Saxena AK, Panhotra BR, Uzzaman W, Venkateshappa CK. The role of the Staphylococcus aureus nasal carriage and type of vascular access in the outcome of high-risk patients on hemodialysis. J Vasc Access. 2002;3(2):74–9.
Dopirak M, Hill C, Oleksiw M, Dumigan D, Arvai J, English E, et al. Surveillance of hemodialysis-associated primary bloodstream infections: the experience of ten hospital-based centers. Infect Control Hosp Epidemiol. 2002 Dec;23(12):721–4.