Bacteriology of Blood Stream infections in Patients on Hemodialysis and Antibiotics Susceptibility Pattern

Abstract

Background Patients requiring hemodialysis are at high risk for blood stream infection (BSI) mainly due to Gram-positive bacteria.. Within gram positive bacteria Staphylococcus aureus (S. aureus) and coagulase negative staphylococci (CoNS) are most common. 1 BIS due to methicillin resistant S. aureus (MRSA) has been found to have a higher attributable mortality than methicillin susceptible S. aureus (MSSA). 2 Although the incidence of MRSA is emerging threat, there is no study of BSI in persons under the course of HD in Nepal. Besides, the etiology of BSI is poorly characterized in this country, mainly due to limited laboratory resources, a poor recording system and an inadequate number of trained personnel. This study was thus designed to investigate the antibiotic resistance patterns of bacterial isolates during blood culture from HD patients. Methods Ethical considerations This study was conducted with the approval of the committee of National College and National Kidney Center and declaration of Helsinki was strictly followed.

Blood stream Infections in chronic hemodialysis patients - characteristics and outcomes

“…This lower reported incidence of BSI was probably related by successful implementation evidence-based preventive infection control strategies which were intensified in HD units worldwide in recent years [15], such as strict adherence to hand hygiene protocols, screening and isolation of patients with MDR pathogens and Clostridium difficile, and sterile attendance to catheters. Despite these measures and similar to other reports almost a third of the BSI were due to resistant organisms [16,17]. This is an important finding because resistant pathogens are associated with an increased risk of mortality, which may be due to the pathogenicity of the bacteria itself and/or inadequate initial empiric antibiotic therapy [18].…”

“…There is an increasing body of evidence demonstrating worldwide changes in the pattern of pathogens causing BSI in HD patients [19][20][21]. The high prevalence of gram-negative bacteremia in our study is unusual as BSI in HD patients are mostly caused by gram-positive bacteria [16]. Gram positive bacteria commonly reside on the colonizing areas around the catheter site insertion commonly used to deliver HD.…”