Levantamento sobre a infecção na inserção do cateter de duplo lúmen

Abstract

Objective: The purpose of this study was to identify the infection rate, etiologic agent, infectious complications and the double-lumen catheter permanence in one same period in alternating years. Methods: This retrospective study was carried out in the Center of Hemodiálysis of the Hospital de Base de São José do Rio Preto-SP. All patients who presented infection in the double-lumen catheter insertion site within the period of the survey were included. Results: It was reported that of the 80 patients undergoing hemodialysis treatment in the first period, from January to June 2002, 21% of the patients were using catheter. Three years later, 186 patients were in the same conditions, and of these, 10.7% was being treated with catheter therapy. The bloodstream infections were reduced by 9.4% in the last period. Bacteremia was the main prevailing infectiou complication. The Staphylococcus aureus was the most prevalent etiologic agent and the average doublelumen catheter permanence time was of 43 days in both periods of the study. Conclusion: This study revealed that there was a significant improvement as for the infection indexes in that population. RESUMENObjetivo: Identificar el índice de infección, el agente etiológico, las complicaciones infecciosas y el tiempo de permanencia del catéter de doble lumen en un mismo período en años alternos. Métodos: Se trata de un estudio retrospectivo realizado en el Centro de Hemodiálisis del Hospital de Base de São José de Rio Preto-SP, y fueron incluidos todos los pacientes con infección en el lugar de inserción del catéter de doble lumen. Resultados: De los 80 pacientes en tratamiento hemodialítico en el primer período de enero a junio del 2002, el 21% eran portadores de catéter y tres años después de los 186 pacientes en las mismas condiciones, el 10,7% presentaban terapia por catéter. Hubo disminución de infecciones de la corriente sanguínea del 9,4% en el último período. La complicación infecciosa más frecuente fue la bacteremia, y el agente etiológico más encontrado el Staphylococcus aureus, el tiempo promedio de permanencia del catéter fue de 43 días en los dos períodos evaluados. Conclusión: En este estudio se demostró que hubo mejora significativa en cuanto a los índices de infección en esa población.

<b>Prevalence of infection in patients with temporary catheter for hemodialysis in a teaching hospital

“…The highest infection rate related to temporary catheter for hemodialysis occurred among those patients who remained longer with the device, corroborating the literature, which recommends the temporary use for a maximum of three weeks (Grothe et al, 2010;Ribeiro, 2008). The manifestation of the infectious process can only be associated with the use of catheter when using the gold standard diagnosis test.…”

Risk Factors Associated With Temporary Catheter-Related Infection in Patients on Dialysis Treatment

“…The literature reports that patients using temporary catheters have about 4 to 18% of bacteremia rates comprising eight thousand average annual cases of sepsis and other device-related infections. 27 As for insertion site, the jugular, subclavian and femoral veins were used. The literature describes the jugular vein is the favorite access.…”

Hemodiálise: análise das taxas de infecção relacionadas aos acessos

“…Atualmente, considera-se que o índice de infecção nos serviços de saúde constitui um dos principais indicadores da qualidade da assistência 12,13 . Ainda aponta como o principal responsável por cerca de 48 a 73% das bacteremias que ocorrem nos pacientes em hemodiálise 5 .…”

“…Sobre o tempo de permanência podemos relacionar com complicações infecciosas. Estudos afirmam que grande parte dos pacientes que permanecem com o cateter num período superior a 30 dias, fica mais vulnerável a infecção, necessitando muitas vezes de tratamento com antibióticos 5,12,13,19 .…”