Surveillance System of Hemodialysis-Associated Infections in a Pediatric Unit

Sucupira, Carolina; Abramczyk, Marcelo Luiz; Carvalhaes, João Tomás de Abreu; Moraes-Pinto, Maria Isabel de

doi:10.1086/665312

Cited by 5 publications

(2 citation statements)

References 9 publications

(18 reference statements)

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“… 4 , 5 Most reports on this subject focus specifically on bloodstream infections (BSI) or local access infection (LAI). 6 , 7 Also, the vast majority of studies were conducted in developed countries. 4 Since benchmarking is a useful tool for measuring the effectiveness of infection control policies, data on the incidence of HAIs in hemodialysis in developing countries are needed.…”

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confidence: 99%

Epidemiology of healthcare-associated infections among patients from a hemodialysis unit in southeastern Brazil

Albuquerque

Cavalcante

Ponce

et al. 2014

The Brazilian Journal of Infectious Diseases

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Patients submitted to hemodialysis are at a high risk for healthcare-associated infections (HAI). Presently there are scarce data to allow benchmarking of HAI rates in developing countries. Also, most studies focus only on bloodstream infections (BSI) or local access infections (LAI). Our study aimed to provide a wide overview of HAI epidemiology in a hemodialysis unit in southeastern Brazil. We present data from prospective surveillance carried out from March 2010 through May 2012. Rates were compared (mid-p exact test) and temporally analyzed in Shewhart control charts for Poisson distributions. The overall incidence of BSI was 1.12 per 1000 access-days. The rate was higher for patients performing dialysis through central venous catheters (CVC), either temporary (RR=13.35, 95% CI=6.68-26.95) or permanent (RR=2.10, 95% CI=1.09-4.13), as compared to those with arteriovenous fistula. Control charts identified a BSI outbreak caused by Pseudomonas aeruginosa in April 2010. LAI incidence was 3.80 per 1000 access-days. Incidence rates for other HAI (per 1000 patients-day) were as follows: upper respiratory infections, 1.72; pneumonia, 1.35; urinary tract infections, 1.25; skin/soft tissues infections, 0.93. The data point out to the usefulness of applying methods commonly used in hospital-based surveillance for hemodialysis units.

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confidence: 99%

Epidemiology of healthcare-associated infections among patients from a hemodialysis unit in southeastern Brazil

Albuquerque

Cavalcante

Ponce

et al. 2014

The Brazilian Journal of Infectious Diseases

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“…Catheter-related infections encompass exit site infections (ESI), tunnel infections, and bloodstream infectious (BSI) [4]. There is a substantial amount of literature on this subject; however, the most papers focused specifically on BSI [4][5][6].…”

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confidence: 99%

Epidemiology and outcome of exit site infection catheter related among patients from a Brazilian haemodialysis unit

2016

J Urol Nephrol

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Patients undergoing haemodialysis (HD) are at high risk for healthcare-associated infections. There are scarce data on epidemiology of exit site infection (ESI) related to tunneled central venous catheter (CVC) and the most studies focused only on bloodstream infections (BSI) and were performed in developed countries. Our study aimed to provide a wide overview of ESI epidemiology in a Brazilian HD unit. We presented data from prospective surveillance carried out from March 2010 through March 2015. The overall incidence of ESI was 3.50 per 1,000 catheters-days. Risk factors for ESI were presence of diabetes and tunneled CVC implanted in femoral site (RR=1.56, 95% CI=1.35-1.89 and RR=1.62, 95% CI=1.22-1.94, p<0.05, respectively). The most frequent agents of ESI were Gram-negative (69%), mainly Serratia marcences, E coli, Proteus mirabillis, Pseudomonas aeruginosa and Klebsiela ESBL. Across the time periods, there was change in etiologic agents: Pseudomonas and ESBL agents became more frequent, while Proteus and E. coli became less frequent (p<0.05). Among Grampositive agents, 59% were resistant to methicillin. On the other hand, Gram-negative bacilli were not often multidrug-resistant. Catheter was removed in 17% due to unsuccessful treatment of ESI and it was associated with Pseudomonas (p=0.04) and BSI caused by the same agent of ESI (p=0.03). Catheter survival was shorter in ESI group (log rank=2.92, p<0.001). As conclusion, ESI rate was high on HD patients, and diabetes and femoral site of CVC were identified as risk factors for it. Catheter survival was shorter in patients who had ESI and catheter removal was associated with Pseudomonas agent and ESI plus BSI. Although Gram negative agents were more frequent, most of them were not resistant to quinolone, aminoglycoside and third generation cephalosporin. Our data suggest the routine application of topical antibiotic ointments to prevent ESI related to CVC caused by Gram negative agents.

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Antibiotic Stewardship in the Pediatric Dialysis Unit

Newland

Neu

2021

Pediatric Dialysis

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Surveillance System of Hemodialysis-Associated Infections in a Pediatric Unit

Cited by 5 publications

References 9 publications

Epidemiology of healthcare-associated infections among patients from a hemodialysis unit in southeastern Brazil

Epidemiology of healthcare-associated infections among patients from a hemodialysis unit in southeastern Brazil

Epidemiology and outcome of exit site infection catheter related among patients from a Brazilian haemodialysis unit

Antibiotic Stewardship in the Pediatric Dialysis Unit

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