Journal article
Catheter-Related Bloodstream Infections in Patients on Emergent Hemodialysis
Infection control and hospital epidemiology, Vol.37(3), pp.301-305
03/2016
DOI: 10.1017/ice.2015.293
PMID: 26607662
Abstract
This study had 2 objectives: (1) to describe the epidemiology of catheter-related bloodstream infections (CRBSI) in patients with end-stage renal disease (ESRD) who have no access to scheduled dialysis and (2) to evaluate whether a positive culture of the heparin-lock solution is associated with subsequent development of bacteremia.
Retrospective observational cohort design for objective 1; and prospective cohort design for objective 2.
The study was conducted in a 770-bed public academic tertiary hospital in Dallas, Texas. The participants were patients with ESRD undergoing scheduled or emergent hemodialysis.
We reviewed the records of 147 patients who received hemodialysis between January 2011 and May 2011 and evaluated the rate of CRBSI in the previous 5 years. For the prospective study, we cultured the catheter heparin-lock solution in 62 consecutive patients between June 2012 and August 2012 and evaluated the incidence of CRBSI at 6 months.
Of the 147 patients on emergent hemodialysis, 125 had a tunneled catheter, with a CRBSI rate of 2.61 per 1,000 catheter days. The predominant organisms were Gram-negative rods (GNR). In the prospective study, we found that the dialysis catheter was colonized more frequently in patients on emergent hemodialysis than in those on scheduled hemodialysis. Colonization with GNR or Staphylococcus aureus was associated with subsequent CRBSI at 6 months follow-up.
Patients undergoing emergent hemodialysis via tunneled catheter are predisposed to Gram-negative CRBSI. Culturing the heparin-lock solution may predict subsequent episodes of CRBSI if it shows colonization with GNR or Staphylococcus aureus. Prevention approaches in this population need to be studied further.
Details
- Title: Subtitle
- Catheter-Related Bloodstream Infections in Patients on Emergent Hemodialysis
- Creators
- Elizabeth Kuo - 3Division of Nephrology,Department of Internal Medicine,University of Texas Southwestern Medical Center,Dallas,TexasChristian A Rojas-Moreno - 1Division of Infectious Diseases,Department of Internal Medicine,University of Texas Southwestern Medical Center,Dallas,TexasDaniel Spiegel - 2University of Texas Southwestern Medical School,Dallas,TexasVenkata Yalamanchili - 3Division of Nephrology,Department of Internal Medicine,University of Texas Southwestern Medical Center,Dallas,TexasHenry Quinones - 3Division of Nephrology,Department of Internal Medicine,University of Texas Southwestern Medical Center,Dallas,TexasPranavi V Sreeramoju - 1Division of Infectious Diseases,Department of Internal Medicine,University of Texas Southwestern Medical Center,Dallas,TexasJames P Luby - 1Division of Infectious Diseases,Department of Internal Medicine,University of Texas Southwestern Medical Center,Dallas,Texas
- Resource Type
- Journal article
- Publication Details
- Infection control and hospital epidemiology, Vol.37(3), pp.301-305
- DOI
- 10.1017/ice.2015.293
- PMID
- 26607662
- ISSN
- 0899-823X
- eISSN
- 1559-6834
- Language
- English
- Date published
- 03/2016
- Academic Unit
- Nephrology; Internal Medicine
- Record Identifier
- 9984094534702771
Metrics
17 Record Views