Surveillance of hemodialysis related infections: a prospective multicenter study

Abstract

As in many countries, there is neither a surveillance system nor a study to reveal the hemodialysis (HD) related infection rates in Turkey. We aimed to investigate the infection rate among HD outpatients and implement CDC’s surveillance system. A multicenter prospective surveillance study is performed to investigate the infection rate among HD patients. CDC National Healthcare Safety Network (NHSN) dialysis event (DE) protocol is adopted for definitions and reporting. During April 2016–April 2018, 9 centers reported data. A total of 199 DEs reported in 10,035 patient-months, and the overall DE rate was 1.98 per 100 patient-months. Risk of blood culture positivity is found to be 17.6 times higher when hemodialysis was through a tunneled catheter than through an arteriovenous fistula. DE rate was significantly lower in patients educated about the care of their vascular access site. Staphylococcus aureus was the most causative microorganism among mortal patients. Outcomes of DEs were hospitalization (73%), loss of vascular access (18.2%), and death (7.7%). This first surveillance study revealed the baseline status of HD related infections in Turkey and showed that CDC National Healthcare Safety Network (NHSN) DE surveillance system can be easily implemented even in a high workload dialysis unit and be adopted as a nationwide DE surveillance program.

Hemodialysis-Related Infections: A 4-Year Surveillance

“…Moreover, it was found that S. aureus was the most common pathogen for CVC infection. This finding is consistent with many other studies 5,14,15 , however S. aureus in this study was non-resistant to methicillin.…”

“…This contrasted with CVC, which had the lowest prevalence but the highest incidence of all events. This was comparable to other studies [13][14][15] and the NHSN 5 .…”

“…A total of 79 infection-related dialysis events were reported in this study, with the overall incidence rate being 3.45 per 100 patient-months; the incidence rate was higher than in other countries; which was 1.4-3.1 per 100 patient-months [13][14][15] . In addition, the death rate was 9.4% (3/32), also higher than in other countries 13,15 . Previously, no relevant studies have been conducted in Thailand.…”

Vascular Access Related Infections in Hemodialysis Children and the Impact of Implementation of CDC Guidelines and Tools on the control of these infections: A Single Centre Experience from Egypt

“…Among these cases, 46 (62.2%) were de nitive/probable CRBSIs and 28 (37.8%) were culture negative possible CRBSIs(7). WhileBhojaraja et al, (2022), in a study conducted on 882 Patients aged ≥ 18 with 921 catheters either on maintenance HD or with acute kidney injury, reported 212 (23%) had Our results regarding the higher rate of infections in NTVCs and in TVCs, compared to AVFs, though insigni cant in TVCs are comparable with the results ofHasanoglu et al, (2022), a multicenter prospective surveillance study in Turkey. They reported that the risk of bacteremia was 17.6 times higher in patients of different ages receiving HD via CVC, than the patients with AVF (9) Mohamed et al, (2019).…”

“…* days from the start of the study for old vascular access inserted before the study or days from insertion for new vascular access inserted during the study till non-functioning or the end of the study Table (6): Incidence of infection per 1000 vascular access days in the 2nd year * days from the start of the study for old vascular access inserted before the study or days from insertion for new vascular access inserted during the study till non-functioning or the end of the study Incidence of different types of infection in 1000 catheter days as well as a comparison between rst and second years of the study regarding vascular access status are shown in tables (7), (8) and(9). Table(7): Incidence of different types of catheter related infections per 1000 catheter days in the rst year P1: Comparison between CRBSI vs. Exit site infections P2: Comparison between CRBSI vs.…”