Clinical characteristics, risk factors and microbiology of infections in patients receiving chronic hemodialysis

Rteil, Ali; Kazma, Jamil; Sawda, Jack El; Gharamti, Amal; Koubar, Sahar H.; Kanafani, Zeina A.

doi:10.1016/j.jiph.2020.01.314

Cited by 10 publications

(19 citation statements)

References 23 publications

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“…According to Rteila et al (2020), comorbidities are related to an increased risk of bloodstream infections among patients on HD.…”

Section: Resultsmentioning

confidence: 99%

“…Similar data were described in a report presented by the USRDS (2018), in which 31% of individuals on HD died from cardiovascular causes, 8% from infections, 3% from neoplasms, 32% from other causes, and 26% from unknown or unreported causes. A patient's clinical condition contributes to this outcome, as do other chronic comorbidities, immune status, tobacco use, nutritional status, and skin integrity (Rteila et al, 2020).…”

Section: Resultsmentioning

confidence: 99%

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Chronic Kidney Disease: Clinical and Epidemiological Scenario of Patients in Hemodialysis

Campos¹,

Toffoli-Kadri²,

Matos³

2021

GJHS

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OBJECTIVE: To describe the clinical and epidemiological scenario of patients with chronic kidney disease undergoing hemodialysis. METHOD: Retrospective study with secondary data collected from the medical records of patients over 18 years of age on hemodialysis from January 2016 to December 2018. RESULTS: 507 patients underwent ambulatory and/or hospital hemodialysis during the study period. From these, 494 participants were included, comprising 383 who were still under treatment at the end of the study period and 111 who died during the study period. The majority of hemodialysis patients were male, with a mean age of 56.6 years, non-white (77.4%), in a stable relationship (51.6%), retired (54.9%), and with low education (73.9%). Most participants started hemodialysis with the use of a central venous catheter (83.3%), which was maintained for 43.8% of the treatment time. Participants used an average of 18.91 medications daily. More than half of the deaths occurred during the first two years of treatment, with 30.6% of these occurring in the first 12 months of hemodialysis. Evaluation of the results of the clinical outcome of death demonstrated a relationship between age (p= 0.003), number of comorbidities (p = 0.009), time using a central venous catheter (p = 0.025), and white ethnicity (p = 0.021). Septic shock was the main cause of death (56.8%). CONCLUSION: Some factors related to the prognosis of the disease cannot be changed, such as age and white ethnicity. However, greater attention to the management and adequate monitoring of comorbidities is necessary, as well as a reduction in the time spent using a central venous catheter. Due to polymedication, pharmacotherapeutic monitoring is indicated, both for the prevention of drug related problems and for discussions concerning drug discontinuation.

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“…According to Rteila et al (2020), comorbidities are related to an increased risk of bloodstream infections among patients on HD.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Chronic Kidney Disease: Clinical and Epidemiological Scenario of Patients in Hemodialysis

Campos¹,

Toffoli-Kadri²,

Matos³

2021

GJHS

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“…Infections due to multidrug-resistant organisms (MDROs) were defined by the World Health Organization (WHO) as one of the current greatest challenges in Medicine [ 3 ]. MDRO infections are relatively prevalent among dialysis patients [ 4 ], since these patients are subjected to high colonization pressure (facilitating “patient-to-patient transmission” of MDROs) and high selective pressure (facilitating “emergence of resistance” among the patient’s own non-MDRO susceptible strains) [ 4 ]. Delay in administration of appropriate antimicrobial therapy (DAAT) is common in MDRO infections [ 5 ] and is the strongest independent modifiable predictor of mortality in septic shock [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Delay in administration of appropriate antimicrobial therapy (DAAT) is common in MDRO infections [ 5 ] and is the strongest independent modifiable predictor of mortality in septic shock [ 5 ]. Therefore, it is important to avoid DAAT among certain hemodialysis septic patients suspected of having MDRO infection while avoiding usage of overly broad-spectrum coverage among hemodialysis patients at lower risk for MDROs [ 4 ]. Our study aim was to explore the epidemiology of MDRO sepsis among chronic ambulatory hemodialysis patients.…”

Section: Introductionmentioning

confidence: 99%

The Epidemiology of Multidrug-Resistant Sepsis among Chronic Hemodialysis Patients

et al. 2022

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Sepsis is one of the leading causes of hospitalization and death among hemodialysis patients. Infections due to multidrug-resistant organisms (MDROs) are common among these patients, but empiric broad-spectrum coverage for every septic patient is associated with unfavorable outcomes. A retrospective case–control study was conducted at Shamir Medical Center, Israel (July 2016–April 2020), to determine predictors of MDRO infections among septic (per SEPSIS-3) ambulatory adult hemodialysis patients with permanent dialysis access (i.e., fistula, graft, or tunneled Perm-A-Cath). MDROs were determined according to established definitions. Least Absolute Shrinkage and Selection Operator (LASSO) regression was used to construct a prediction score and determine its performance. Of 509 patients, 225 (44%) had microbiologically confirmed infection, and 79 patients (35% of 225) had MDROs. The eventual independent predictors of MDRO infections were Perm-A-Cath access (vs. fistula or graft, aOR = 3, CI-95% = 2.1–4.2) and recent hospitalization in the previous three months (aOR = 2.3, CI-95% = 1.6–3.3). The score to predict MDRO sepsis with the highest performances contained seven parameters and displayed an area under the receiver operating characteristic curve (ROC AUC) of 0.74. This study could aid in defining a group of hemodialysis patients for which empiric broad-spectrum agents could be safely avoided.

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“…Hemodiyaliz hastalarında morbitide ve mortaliteyi etkileyen en önemli faktörlerden ilki kardiyovasküler hastalıklar ikincisi ise enfeksiyöz komplikasyonlardır (17) . Hemodiyalizin ekstrakorporeal bir tedavi yöntemi olması ve invaziv işlem içermesi, hastane ortamında diğer diyaliz hastalarıyla aynı ortamda alınan tedaviler ve sağlık personeli kaynaklı bulaş, bağışıklığı baskılanmış olan bu hasta grubunu daha da risk altına sokar.…”

Section: Introductionunclassified

Investigation of Nasal Methicillin Resistant Staphylococcus aureus and Coagulase Negative Staphylococcus Carriage by Various Methods in Hemodialysis Patients in Nevşehir Province

ÖZMEN

Polat²,

YALAP

et al. 2022

ANKEM Dergisi

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Investigation of Nasal Methicillin Resistant Staphylococcus aureus and Coagulase Negative Staphylococcus Carriage by Various Methods in Hemodialysis Patients in Nevşehir ProvinceInfection is one of the important factors affecting morbidity and mortality in hemodialysis patients. Access to dialysis, frequent hospitalizations, and contact with healthcare personnel increase the risk of infection. Nasal Staphylococcus aureus and other staphylococci may cause vascular access infections through carrier patients and staff. In this study, nasal S. aureus and coagulasenegative Staphylococcus (CNS) carriers were detected in hemodialysis patients and staff, and methicillin resistance in isolates was investigated by various methods. In this way, it was aimed to contribute to the assessment of nosocomial infection risk. Between November 2019 and March 2020, 93 hemodialysis patients, 41 female, 52 male, and 15 dialysis personnel treated at Nevşehir State Hospital, H. Mustafa and Türkan Öbekli Dialysis Center were included in the study. Nasal swab samples were obtained after the informed consent form was signed. Methicillin resistance in staphylococci isolated from the samples was determined by the Kirby-Bauer disk diffusion method, PBP-2a latex agglutination (LA) test, and real-time polymerase chain reaction (RT-PCR). Of the patient samples (n=93), 18 (19.3%) had S. aureus, 11 (11.8%) had CNS; of the personnel samples (n=15) CNS was isolated from three (20%) and S. aureus from one (6.6%). It was determined that one of the S. aureus isolated from the patients was methicillin-resistant (1%); the rest (18.2%) and all CNS (11.8%) were methicillin-susceptible by disk diffusion method. While all of the CNS (20%) in the personnel samples were susceptible to methicillin, only S. aureus was resistant (6.6%). The PBP-2a LA test and RT-PCR were performed on all S. aureus isolates (n=19); the PBP-2a

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Clinical characteristics, risk factors and microbiology of infections in patients receiving chronic hemodialysis

Cited by 10 publications

References 23 publications

Chronic Kidney Disease: Clinical and Epidemiological Scenario of Patients in Hemodialysis

Chronic Kidney Disease: Clinical and Epidemiological Scenario of Patients in Hemodialysis

The Epidemiology of Multidrug-Resistant Sepsis among Chronic Hemodialysis Patients

Investigation of Nasal Methicillin Resistant Staphylococcus aureus and Coagulase Negative Staphylococcus Carriage by Various Methods in Hemodialysis Patients in Nevşehir Province

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