A prospective study of hemodialysis access-related bacterial infections

Abdul-Rahman, Ibrahiem Saeed; Al-Mueilo, Samir; Bokhary, Huda A.; Ladipo, G. O. A.; Al-Rubaish, Abdullah M.

doi:10.1007/s10156-002-0184-8

Cited by 67 publications

(42 citation statements)

References 33 publications

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“…In previous studies of non-cuffed catheters, as used in this report, the microbiota of the skin at site of implantation were found to be the main source for catheter colonization, and the microorganisms most often associated with catheter infections were S. epidermidis and S. aureus, [8,12,13] which was also observed here.…”

Section: Discussionsupporting

confidence: 67%

“…This suggests that continuous venipunctures of the fistulas also facilitate bacterial access to the systemic circulation and could be the cause of some of the infections observed in hemodialysis patients with AV fistulas, although infectious complications are, by far, much more common in hemodialysis patients with artificial devices. [8] Although it is a single-center study with a low number of patients, the high rates of colonization and bacteremia related to the use of temporary catheters observed in the present study, the high rates of asymptomatic bacteremia episodes, and the occurrence of infectious complications if the catheters are not removed justify the proposal of routine blood collections for culture in order to monitor bacterial colonization in hemodialysis patients with temporary dual-lumen catheters. In cases of positive blood cultures, without another apparent infectious site, the catheter should be removed, although there is no need to prescribe antibiotics if the patients remain asymptomatic.…”

Section: Discussionmentioning

confidence: 99%

“…[8] The reported incidence of bacteremia varies greatly, depending on the catheter type, length of catheter permanence, the cuff and tunnel used, and the central vein used. [18] In this study, the catheter colonization rate was 23.4/ 1000 catheter/days, with an incidence rate of 9.2 episodes/bacteremia/1000 catheter/days, and 68.9% of the patients presented at least one catheter with colonization evidence during the course of this study.…”

Section: Discussionmentioning

confidence: 99%

“…[4,[8][9][10][11][12][13][14] We conducted a prospective study on patients submitted to hemodialysis with temporary non-cuffed dual-lumen catheters in order to assess the incidence of bacterial colonization, risk factors for catheter-related bacteremia, and clinical outcomes of infectious episodes.…”

Section: Lwc De Freitas Et Almentioning

confidence: 99%

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Bacterial Colonization in Hemodialysis Temporary Dual Lumen Catheters: A Prospective Study

Freitas

Neto²,

Nascimento

et al. 2008

Renal Failure

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Aims. The use of hemodialysis temporary dual-lumen catheters is often complicated by infections, which may be a significant cause of death among patients with end stage renal disease (ESRD). The aim of this study was to assess the incidence of bacteremia and bacterial colonization related to non-tunneled, non-cuffed, dual-lumen temporary catheters in patients with ESRD submitted to hemodialysis. Methods. This study included 29 patients with ESRD. After catheter implantation, patients were monitored throughout the period of catheter permanence by means of blood samples collected weekly from a peripheral vein. Bacteria were isolated and identified according to CLSI recommendations. When catheters were removed for any reason, their tips were evaluated microbiologically. Results. A total of 194 blood samples from the 29 patients implanted with 55 catheters were analyzed. Of these, 15.5% (30 samples) demonstrated bacterial growth, principally Staphylococcus epidermidis (64.5%). Twenty patients (68.9%) presented at least one positive blood culture during follow-up. The median time for catheter colonization was 18.5 days (95% CI: 16.8-30.3). Of the 55 catheters implanted, 28 (50.9%) showed bacterial colonization, corresponding to 23.4 episodes/1000 catheter/days and 9.2 episodes of bacteremia /1000 catheter/days. Fifteen of 28 catheter tips analyzed showed bacterial growth (53.5%). In 14 of these (93.3%), there was agreement between the isolates from the catheter tip and blood cultures. Of 24 episodes of positive blood cultures from 20 different patients in 17 episodes (70.8%), the patients showed no clinical signs or symptoms of bacteremia. Conclusions. The high incidence of catheter colonization, the correlation between blood and catheter tip cultures, and the occurrence of frequent cases of asymptomatic bacteremia justify the proposal of routine peripheral blood collections to monitor patients undergoing hemodialysis with temporary dual-lumen catheters.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Lwc De Freitas Et Almentioning

confidence: 99%

See 2 more Smart Citations

Bacterial Colonization in Hemodialysis Temporary Dual Lumen Catheters: A Prospective Study

Freitas

Neto²,

Nascimento

et al. 2008

Renal Failure

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“…S aureus and coagulase-negative staphylococci each accounted for 36% of the BSIs (7). Investigators in Saudi Arabia had similar findings, with a BSI rate of 3.95/1000 dialysis sessions from August 1999 to January 2001 (9). In this study, rates ranged from 1.29/1000 dialysis sessions for AV fistulae/grafts to 8.30/1000 dialysis sessions for nontunnelled catheters.…”

Section: N a Previous Issue Of The Canadian Journal Of Infectioussupporting

confidence: 66%

Central Venous Catheter-Associated Bloodstream Infections in Hemodialysis Patients: Another Patient Safety Bundle?

Johnston

Conly

2006

Canadian Journal of Infectious Diseases and Medical Microbiolog

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In a previous issue ofThe Canadian Journal of Infectious Diseases & Medical Microbiology, we reviewed the 'Safer Healthcare Now!' campaign's focus on reducing central venous catheter (CVC)-associated bloodstream infections (BSIs) as a way of improving patient safety (1). This initiative is focused on preventing CVC-associated BSIs in intensive care units. However, other patient groups are also at risk for CVC-related BSIs, suggesting that there are other individuals who would benefit from preventive efforts. A 1996 hospital-wide survey of nosocomial bacteremia in an Israeli university hospital (2) found that 9% of infected patients were on chronic hemodialysis. Surveillance in 73 hospitals in England between 1997 and 2001 found a CVC BSI rate of 21/1000 nephrology patients at risk who were hospitalized in teaching hospitals (3). This rate was similar to that found in special care neonatal units, although not quite one-half that of patients in a general intensive care unit. In a population-based survey performed in the Calgary Health Region from 2000 to 2002 (4), hemodialysis (HD) posed the greatest risk (RR 208.7; 95% CI 142.9 to 296.3) for acquiring severe BSI.

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Interventions for preventing infectious complications in haemodialysis patients with central venous lines

McCann

Moore

2008

Cochrane Database of Systematic Reviews

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A prospective study of hemodialysis access-related bacterial infections

Cited by 67 publications

References 33 publications

Bacterial Colonization in Hemodialysis Temporary Dual Lumen Catheters: A Prospective Study

Bacterial Colonization in Hemodialysis Temporary Dual Lumen Catheters: A Prospective Study

Central Venous Catheter-Associated Bloodstream Infections in Hemodialysis Patients: Another Patient Safety Bundle?

Interventions for preventing infectious complications in haemodialysis patients with central venous lines

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