Temporary Catheter Infections in Hemodialysis Patients

Abstract

In this study, we aimed to determine the frequencies of catheter exit-site infection (CESI), catheter-related bloodstream infection (CR-BSI) and catheter colonization (CC); causative microorganisms; and resistance patterns in patients with temporary hemodialysis catheters. From March 1999 to March 2000, 67 hemodialysis patients (38 males, 29 females; median age: 52, range: 17-84) were evaluated. The CDC criteria were used to diagnose CESI, CR-BSI and CC. The tips of catheters were cultured by Maki's method. At the same time, two different blood cultures, one from peripheral vein and the other through the catheter lumen were drawn. Swab cultures from the catheter exit sites were also performed. The isolation and identification of bacteria were performed by conventional methods and the susceptibility testing by the Kirby-Bauer method. CESI, CR-BSI and CC were found in, respectively, 20 (29.8%), 16 (23.8%) and 11 (16.4%) patients. The etiologic agents in CR-BSI were as follows: Staphylococcus aureus (5), coagulase-negative staphylococci (2), Enterococcus sp. (1), Escherichia coli (1), Acinetobacter sp. (1) and Proteus sp. (1). Methicillin-resistant coagulase-negative staphylococci and methicillin-resistant S. aureus were found in proportions of 45.5% and 63.6% in CESI and CR-BSI+CC. The only risk factor for the development of CR-BSI and CC was intravenous drug use. In our center, the majority of CESI, CR-BSI and CC were due to staphylococci and there was a high rate of methicillin resistance.

Infecções em pacientes submetidos a procedimento hemodialítico: revisão sistemática

“…(41) Twenty seven full articles and six abstracts were analyzed. Of the analyzed abstracts (14,24,25,29,33,41) only one had all the information needed to analyze the factors compiled in this study.…”

“…Criteria to define different infection topographies varied, 15 (44.5%) used their own criteria, (4,(10)(11)(12)15,18,28,30,31,(34)(35)(36)(37)(38)40) 12 (36.4%) CDC criteria , (13,16,17,(20)(21)(22)25,26,29,32,33,39) 3 (9.1%) nationally set criteria (19,23,27) and 3 (9.1%) did not cite the criteria used. (14,24,41) Regarding VARI, authors who used their own criteria defined, for infection on the access site, the presence of pus and phlogistic signs surrounding insertion.…”

Two heterogeneously vancomycin-intermediate clinical isolates of methicillin-sensitive and methicillin-resistant Staphylococcus aureus in a Turkish university hospital: brief report of a surveillance study

“…Although MRSA rates are very high in our country [11][12][13][14][15], the predicted high prevalence of hetero-VISA among them [16] has not yet been confirmed [15,17], except one report from The Netherlands regarding detecting Turkish hetero-VISA isolates of unknown origin [18]. In support of the results of Nakipoglu et al [15], a recent study from Malta reports one of the highest prevalence rates of MRSA in Europe, along with teicoplanin heteroresistance and vancomycin susceptibility [19].…”

Les infections liées aux cathéters veineux centraux dans les hôpitaux universitaires de Bamako

“…Il est cependant d'accès facile et surtout adapté aux situations d'urgence. Le risque infectieux est plus observé au niveau du site fémoral que le site jugulaire (9). Le site sousclavier expose le moins à l'infection.…”