The predictors of catheter-related bloodstream infections in patients undergoing hemodialysis: A single center experience

Abstract

Background: Here we aimed to investigate the predictors of catheter-related bloodstream infections (CRBSI) in patients with acute kidney injury or chronic kidney disease who required renal replacement therapy through a non-tunneled hemodialysis catheter. Methods: A total of 111 patients who received non-tunneled hemodialysis catheters were retrospectively evaluated. Patients were divided into two groups; those who developed CRBSI and those who did not. Patient’s demographic data, laboratory results at admission, information regarding catheter infections, and culture results were obtained from electronic medical records. Results: The mean age of the patients was 64 ± 16 years, and 51 of them were male. CRBSI occurred in 14 patients (12.6%). Admission serum albumin level (OR: 0.119, 95% CI: 0.019–0.756, p = 0.024), admission mean platelet volume (OR: 2.207, 95% CI: 1.188–4.100, p = 0.012) and catheter duration (OR: 1.580, 95% CI: 1.210–2.064, p = 0.001) were independent predictors for the CRBSI development. ROC curve analysis demonstrated that a catheter duration of 22 days was predictive for presence of CRBSI (78% sensitivity, 76% specificity, AUC: 0.825, 95% CI: 0.724–0.925, p < 0.001). Conclusions: Prolonged catheter duration, low serum albumin, and high mean platelet volume independently predict the development of CRBSI in patients undergoing hemodialysis for acute kidney injury or chronic kidney disease.

Tunneled dialysis catheter utilization and patency: a retrospective-prospective study from a tertiary care hospital in Karachi Pakistan

“…Individuals with diabetes, a longer catheter and a left internal jugular catheter placement had a considerably increased chance of developing CRBSI. 23,24 However, no meaningful correlation between any component and CRI was found in the current study.…”

Incidence, Risk Factors and Outcomes of Catheter Related Bloodstream Infections Among Adult Filipino Hemodialysis Patients: A Retrospective Cohort Study

“…6,7,11,28,34 Conversely, we also found that a right sided CVC placement and elevated serum albumin levels decreased the risk of developing CRBSI, both of which were also consistent with published studies. 10,31 We attempted to identify infusion related risk factors that may in uence formation of CRBSI. Studies allude to the increased risk of CRBSI with infusion of blood products, intravenous medications and parenteral nutrition via catheter access.…”

“…1,5-9 CRBSI incidence varies from 0.6 to 6.5 episodes per 1000 catheter-days, depending on de nition, local policies for catheter placement and care, and duration of catheterization. 1,5,10,11 Staphylococcus spp. is the most common causative organism, however; infections may also be due to other gram positive or gram negative pathogens.…”

“…1,12,13 CRBSI can also be complicated by catheter dysfunction and metastatic infections such as endocarditis, osteomyelitis, septic arthritis, and epidural abscess. 10,14 Risk factors for CRBSI include previous catheter-related bacteremia, left-sided internal jugular vein catheters, old age, diabetes mellitus, malnutrition, prolonged use, hypoalbuminemia, and immunosuppression. 10,12,15,16 Another evolving problem is the development of multidrug resistant organisms (MDROs).…”

“…10,14 Risk factors for CRBSI include previous catheter-related bacteremia, left-sided internal jugular vein catheters, old age, diabetes mellitus, malnutrition, prolonged use, hypoalbuminemia, and immunosuppression. 10,12,15,16 Another evolving problem is the development of multidrug resistant organisms (MDROs). Risk factors for MDROs include residence in a long-term health facility and recent antibiotic use, both of which are common in patients undergoing hemodialysis.…”