Bloodstream Infections in Hospitalized Hemodialysis Patients

Farhan, Qadeer; Shemin, Douglas; Gillani, Fizza S.; D’Agata, Erika M. C.

doi:10.1016/j.xkme.2019.04.005

Cited by 1 publication

(3 citation statements)

References 8 publications

(13 reference statements)

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“…The United States Renal Data System (USRDS) in its 2020 data report revealed that, while adjusted rates of hospitalization for cardiovascular and other causes decreased over time, the rate of infection-related hospitalizations remained relatively unchanged between 2009 and 2018 2 . Furthermore, it has been found that the rates of bloodstream infections (BSIs), the most common infections among hemodialysis patients, have increased by 40% between 2003 and 2014 5 .…”

Section: Discussionmentioning

confidence: 99%

“…While gram-positive cocci preponderate as a cause of BSI in hemodialysis patients, recently the proportion of BSIs caused by gram-negative pathogens is increasing, with one study showing a statistically significant increase in gram-negative pathogens and a decrease in Staphylococcus aureus causing BSIs over a 9-year period 5 . Another study showed that a quarter of BSIs were due to gram-negative pathogens resistant to common antimicrobials, with 25% of these isolates only sensitive to colistin 18 .…”

Section: Discussionmentioning

confidence: 99%

“…The National Healthcare Safety Network (NHSN) Dialysis Event Surveillance Protocol defines a bloodstream infection (BSI) as a positive blood culture collected from a hemodialysis patient as an outpatient or within 1 calendar day after hospital admission 4 . These are the most frequently found infections among hemodialysis patients, and are associated with serious morbidity and mortality 5 .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Patterns of microbial resistance in bloodstream infections of hemodialysis patients: a cross-sectional study from Palestine

Abutaha

Al-Kharraz

Belkebir

et al. 2022

Sci Rep

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Bloodstream infections (BSIs) are a prominent cause of death and hospitalization among hemodialysis (HD) patients. The emergence of multidrug-resistant organisms (MDRO) is making the management of these infections more challenging. This study describes the clinical characteristics, microbial profiles and antibiotic resistance patterns in patients with BSIs. A retrospective cross-sectional study was conducted at An-Najah National University Hospital from January 2019 to December 2020. Clinical and demographic data regarding BSIs were collected from the hospital information system. Data regarding bacterial isolates and the antimicrobial resistance of BSIs were collected from the microbiology lab. Data were entered and analyzed using version 21 of the Statistical Package for Social Sciences program (IBM-SPSS). 111 BSIs occurred during the study period, with a rate of 1.5 infections per 100 patient-months. These patients had been on HD for the median duration of 747 (360, 1825) days and 62.2% had already had a BSI before the study period. 118 microorganisms were isolated; 99 (83.89%) were gram-positive and 19 (16.1%) were gram-negative. Among the gram-positive isolates, coagulase-negative staphylococci (CoNS) (88, 74.57%) were predominant. As for the gram-negative isolates, the most frequent were both Stenotrophomonas maltophilia and Escherichia coli, with five (4.23%) positive cultures each. Among the latter, two were Extended-Spectrum Beta-Lactamase producing (ESBL) (1.69%). The most frequently used empiric antibiotics were a combination of vancomycin and gentamicin (27%), followed by vancomycin alone (24.3%). Regarding gram-positive isolates, vancomycin was the most frequently used and effective antibiotic after cultures, whereas for gram-negative bacteria, it was found to be gentamicin. MDROs were defined as those resistant to at least one agent in three or more antimicrobial categories. 89 (75.4%) isolates were found to be MDRO, 85 (85.85%) gram-positive bacteria and 4 (21%) gram-negative bacteria. When comparing patients according to the type of vascular access, 66 (75%) infections with MDRO were found among patients with central venous catheters (CVCs). However, no statistically significant relationship was found between the type of vascular access and infection with MDRO (p = 0.523). MDRO cause a remarkably high proportion of BSIs in Palestinian patients. The results of this study support the empiric use of vancomycin and gentamicin to treat these infections. It is vital that health care providers prevent these infections via instituting and adhering to infection control policies in hemodialysis centers and providing proper antibiotic therapy of limited use and duration when necessary to avoid breeding resistance.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%