scholarly journals Catheter-related blood stream infection in hemodialysis patients with symmetric tunneled non-side-hole hemodialysis catheters

2021 ◽  
pp. 112972982110270
Author(s):  
Michael G Tal ◽  
Alexander S Yevzlin
Keyword(s):  
Bloodstream Infection ◽  
Blood Stream Infection ◽  
Bloodstream Infections ◽  
Blood Stream ◽  
Hemodialysis Patients ◽  
Side Hole ◽  
Hemodialysis Catheter ◽  
Catheter Tip ◽  
Stage Renal Disease ◽  
Catheter Related Bloodstream Infection

Background: Tunneled hemodialysis catheter-related bloodstream infection is a major cause of morbidity and mortality in end-stage renal disease patients. Side holes positioned near the tip of catheters have been linked to formation of thrombi, which, in turn, have been implicated in predisposition to infection. In addition, side holes allow spillage of catheter locking solution, including antibiotics, thereby minimizing the lock solution’s effect on the catheter tip. This study assessed the infection events that occurred in a series of hemodialysis patients using a non-side-hole catheter. Methods: Over a period of 2 years, a novel symmetric-tip non-side-hole catheter was placed in 60 patients. Hemodialysis was performed thrice weekly. Prescribed dialyzer flows were 300–350 mL/min. Catheters were routinely locked with heparin 5000 units/mL between treatments. Patients were followed up for any catheter related complications, specifically infection events. Results: Seven events of catheter-related bloodstream infection occurred for a rate of 0.76 events per 1000 catheter-days, with the first event occurring 9 weeks after insertion. These events were treated by locking the affected catheter with 2 g of clindamycin in 2 mL of heparin 1000 units/mL and administration of intravenous antibiotics, in most cases, for 7–14 days. Two catheters were removed due to infection. Conclusions: Catheter-related bloodstream infections with non-side-hole hemodialysis catheters do occur at a relatively low rate and in this initial preliminary study it seems that most of these infections can be successfully treated without removal of the affected catheters.

scholarly journals Hemodialysis catheter related blood stream infections

2018 ◽  
Vol 6 (2) ◽  
pp. 562
Author(s):  
Tanuja Nambakam Subramanyam ◽  
Girish P. Vakrani
Keyword(s):  
Blood Sample ◽  
Early Result ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Hemodialysis Patients ◽  
Morbidity And Mortality ◽  
Catheter Removal ◽  
Exit Site ◽  
Hemodialysis Catheter ◽  
Catheter Tip

Background: Hemodialysis catheter related blood stream infection (CRBSI) is common cause for sepsis in hemodialysis patients with high morbidity and mortality. It has to be diagnosed promptly for early treatment to avoid serious complications including catheter removal. This prospective study was undertaken to study clinical features, to validate use of cultures drawn from different sites for diagnosis and management of hemodialysis catheter related blood stream infection (CRBSI). As there is paucity of data regarding CRBSI, hence the study was undertaken.Methods: All hemodialysis patients with CRBSI between October 2016 to October 2017 were included. Variables like different catheter position, blood cultures collected from peripheral vein, both catheter hubs, catheter exit site swab, and catheter tip cultures were analyzed with respect to time to culture positivity, microbes and its management were analyzed.Results: Mean duration of hemodialysis catheter inside patient was 24days, most common risk factor for CRBSI was diabetes mellitus (58%) followed by surgery (50%), previous dialysis catheterization within preceding 2months (33%). 30% patients had history of guide wire exchange of catheters previously, most had temporary catheter (88%), most common site of catheter was right internal jugular vein (58%). Cultures showed gram positive organisms in 63%. It was found that same monomicrobial growth was noted in most cultures stating less chances of contamination. Exit site, catheter tip samples and blood sample from catheter’s venous hub yielded early result. It was found that same monomicrobial growth was noted in most cultures stating less chances of contamination. Among complications, 8% had endocarditis, 61% had catheter removal. Average hospital stay was 9days. Deferve scence was noted upon antibiotic therapy and catheter removal in most cases. Death was noted in 8% due to sepsis.Conclusions: CRBSI are major cause of admissions, morbidity and mortality in hemodialysis patients on catheters. Gram positive organisms were commonest pathogens causing CRBSI. Exit site, catheter tip samples and blood sample from catheter’s venous hub yielded early result. Peripheral blood sampling for culture diagnosing was unnecessary. Most requires 2-6weeks systemic antibiotics and catheter removal especially if persistent fever and systemic complications are present.

scholarly journals Tunnelled hemodialysis catheter-related bloodstream infection with Ochrobactrum anthropi: a report of the first two cases from Bulgaria and a brief overview

Folia Medica ◽  
2021 ◽  
Vol 63 (1) ◽  
pp. 148-152
Author(s):  
Biser K. Borisov ◽  
Hristina Y. Hitkova ◽  
Stela P. Linkova
Keyword(s):  
Bloodstream Infection ◽  
Hemodialysis Patients ◽  
High Morbidity ◽  
Ochrobactrum Anthropi ◽  
Central Venous ◽  
Hemodialysis Catheter ◽  
Stage Renal Disease ◽  
End Stage ◽  
Catheter Related Bloodstream Infection

The use of central venous catheters for hemodialysis continues to grow worldwide, despite the efforts of many specialists. Patients with end-stage renal disease have impaired immunity, which is why infections are the most common complication seen in them. It worsens their quality of life and is a major cause of high morbidity and mortality, especially in hemodialysis patients. We report two cases of catheter-related bloodstream infection in hemodialysis patients caused by Ochrobactrum anthropi, which are the first reported cases in Bulgaria and present a brief literature review of the known facts.

scholarly journals Clinical Outcomes and Risk Factors for Tunneled Hemodialysis Catheter-Related Bloodstream Infections

2020 ◽  
Vol 7 (6) ◽  
Author(s):  
Kylie Martin ◽  
Yves S Poy Lorenzo ◽  
Po Yee Mia Leung ◽  
Sheri Chung ◽  
Emmet O’flaherty ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bloodstream Infection ◽  
Jugular Vein ◽  
Insertion Site ◽  
Bloodstream Infections ◽  
Left Internal Jugular Vein ◽  
Hemodialysis Catheter ◽  
Increased Risk ◽  
Catheter Related Bloodstream Infection ◽  
Reduced Risk

Abstract Diabetes and left internal jugular vein insertion site were significantly associated with increased risk of a catheter-related bloodstream infection from a tunneled hemodialysis catheter. Ex-smoker status was significantly associated with reduced risk.

A 2% taurolidine catheter lock solution prevents catheter-related bloodstream infection (CRBSI) and catheter dysfunction in hemodialysis patients

2021 ◽  
Vol 30 (14) ◽  
pp. S24-S32
Author(s):  
Matthias Alexander Neusser ◽  
Irina Bobe ◽  
Anne Hammermeister ◽  
Udo Wittmann
Keyword(s):  
Adverse Events ◽  
Bloodstream Infection ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Technical Problems ◽  
Hemodialysis Catheter ◽  
Catheter Dysfunction ◽  
Lock Solution ◽  
Catheter Lock ◽  
Catheter Related Bloodstream Infection

HIGHLIGHTS 2% taurolidine catheter lock solution without additives is safe and efficient. CRBSI and dysfunction rates compare favorably against other studies in hemodialysis Background: In hemodialysis patients, catheter-related bloodstream infection (CRBSI) and catheter dysfunction are common and cause significant morbidity, mortality, and costs. Catheter lock solutions reduce CRBSI and catheter dysfunction rates, but solutions containing heparin, citrate, or antibiotics are associated with adverse effects. Due to its antimicrobial and antithrombotic properties and benign safety profile, taurolidine is suitable for use in catheter lock solutions. In this study the effectiveness and safety of a catheter lock solution containing 2% taurolidine without citrate or heparin (TauroSept®, Geistlich Pharma AG, Wolhusen, Switzerland) in hemodialysis patients were investigated for the first time. Methods: Data from 21 patients receiving chronic hemodialysis via tunneled central venous catheters with 2% taurolidine solution as a catheter lock were analyzed in a single-center retrospective study and compared with the existing literature in a review. The primary endpoint was CRBSI rate. Secondary endpoints included catheter dysfunction, treatment, and costs; catheter technical problems, resolution, and costs; and adverse events. Data were compared to outcomes with standard lock solutions in the literature. Results: No CRBSIs occurred during the observation period of 5,639 catheter days. The catheter dysfunction rate was 0.71 per 1,000 catheter days, and the catheter dysfunction treatment costs were CHF (Swiss Franc) 543 per patient. No technical problems or adverse events related to the use of 2% taurolidine-containing catheter lock solution were observed. These results compare favorably with other catheter lock solutions. Conclusions: A solution containing 2% taurolidine seems suitable as a hemodialysis catheter lock. In a Swiss cohort, it prevented CRBSI, limited catheter dysfunction, and was cost-efficient.

Clinical usefulness of catheter-drawn blood samples and catheter-tip cultures for the diagnosis of catheter-related bloodstream infections in neonates

2020 ◽  
Vol 41 (7) ◽  
pp. 854-856
Author(s):  
Janita Ferreira ◽  
Paulo Augusto Moreira Camargos ◽  
Viviane Rosado ◽  
Leni Márcia Anchieta ◽  
Roberta Maia de Castro Romanelli
Keyword(s):  
Adverse Events ◽  
Bloodstream Infection ◽  
Efficient Method ◽  
Bloodstream Infections ◽  
Central Venous Catheters ◽  
Blood Sampling ◽  
Central Venous ◽  
Blood Samples ◽  
Catheter Tip ◽  
Catheter Related Bloodstream Infection

AbstractCatheter-drawn blood sampling is an efficient method of diagnosing catheter-related bloodstream infection (CRBSI) in neonates; it has greater sensitivity and accuracy than methods using catheter-tip cultures. No association was detected between catheter-drawn blood sampling and the occurrence of adverse events with central venous catheters.

scholarly journals Pulmonary Embolization with Tunneled Hemodialysis Catheter-Associated Blood Stream Infection: The Perils of Systemic Anticoagulation

2012 ◽  
Vol 4 (2) ◽  
pp. 73-75 ◽  
Author(s):  
Kamel A. Gharaibeh ◽  
Éva Csongrádi ◽  
Michael Shoemaker-Moyle ◽  
Anna Lerant ◽  
Mihály Tapolyai ◽  
...  
Keyword(s):  
Intracranial Hemorrhage ◽  
Blood Stream Infection ◽  
Renal Dialysis ◽  
Blood Stream ◽  
Hemodialysis Catheter ◽  
Individualized Care ◽  
Pulmonary Embolization ◽  
Systemic Anticoagulation ◽  
Stage Renal Disease ◽  
End Stage

A 35-year old African-American male with end-stage renal disease on hemodialysis through a tunneled dialysis catheter (TDC) presented with fever, diffuse aches and generalized distress. Blood cultures (BC) were obtained and empirical broad-spectrum antibiotic therapy started. After urgent renal dialysis, TDC was pulled at the bedside. Chest computed tomography (CT) diagnosed pulmonary embolism and systemic i.v. heparin was initiated. BC grew Gram positive cocci (methicillin-sensitive S. aureus) and cardiac echocardiogram confirmed acute bacterial endocarditis. Due to declined mental status, CT imaging was obtained revealing massive intracranial hemorrhage leading to the patient's death. Further chest CT review revealed only hemodynamically non-significant pulmonary emboli in some segmental and subsegmental arteries. Pulmonary embolization may be an expected occurrence with removal of infected TDC; systemic anticoagulation may not be warranted in such cases and may lead to catastrophic intracranial hemorrhage. This case draws our attention to the perils of rigid adherence to protocol and the failure of considering the needs of special patient cohorts and individualized care.

Catheter-related complications and survival among incident hemodialysis patients in Singapore

2018 ◽  
Vol 19 (6) ◽  
pp. 602-608 ◽  
Author(s):  
Hao-Yun Yap ◽  
Suh-Chien Pang ◽  
Chieh-Suai Tan ◽  
Yi-Liang Tan ◽  
Nicholette Goh ◽  
...  
Keyword(s):  
Risk Factor ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Arteriovenous Fistula ◽  
Bloodstream Infection ◽  
Bloodstream Infections ◽  
Hemodialysis Patients ◽  
Complication Rates ◽  
Exit Site Infection ◽  
Catheter Related Bloodstream Infection

Introduction: Hemodialysis is the main modality of renal replacement therapy in Singapore. However, a majority of the patients in Singapore are initiated on hemodialysis via a catheter. This study examines the complication rates and factors predicting catheter-related bloodstream infections and mortality rates in patients who were initiated on hemodialysis at our institution. Methods: This is a single-center retrospective analysis of incident hemodialysis patients who were initiated on renal replacement therapy between 1 January 2010 and 31 December 2012. Catheter-related bloodstream infection risk factors, organisms, and associated mortality were analyzed. Results: The catheter-related bloodstream infection and exit site infection incidence rates were 0.75 and 0.50 per 1000 catheter days, respectively. The mean duration to first catheter-related bloodstream infection episode was 182.47 ± 144.04 catheter days. Prolonged catheter duration was found to be a risk factor for catheter-related bloodstream infection. Compared to patients initiated on dialysis via arteriovenous fistula, initiation of dialysis via catheter is strongly associated with increased mortality (6.0% vs 14.5%; p = 0.02). In particular, the presence of diabetes mellitus and development of catheter-related bloodstream infection was associated with increased mortality ( p = 0.04 and 0.05, respectively). In addition, patients who began hemodialysis before being seen by a nephrologist were associated with decreased mortality (3.4% vs 13.0%; p = 0.03). Conclusion: In conclusion, prolonged duration of catheter insertion is found to be a risk factor for catheter-related bloodstream infection in hemodialysis patients, and its development is associated with increased mortality. Early referral to a nephrologist and creation of arteriovenous fistula in pre-end-stage renal disease patients are pivotal in improving the outcomes of patients.

scholarly journals Colistin Induced Neurotoxicity in a Patient with End Stage Kidney Disease and Recovery with Conventional Hemodialysis

2015 ◽  
Vol 8 (1) ◽  
pp. 53-55 ◽  
Author(s):  
Radhika Chemmangattu Radhakrishnan ◽  
Shibu Jacob ◽  
Harish Ratnakarrao Pathak ◽  
Veerasami Tamilarasi
Keyword(s):  
Bacterial Infections ◽  
Blood Stream Infection ◽  
Signs And Symptoms ◽  
Blood Stream ◽  
Multidrug Resistant ◽  
End Stage Kidney Disease ◽  
Neurotoxic Effects ◽  
Stage Renal Disease ◽  
End Stage ◽  
Conventional Hemodialysis

Colistin is widely used in the treatment of multidrug resistant bacterial infections. Nephrotoxicity and neurotoxicity are risks associated with colistin use. We report the case of a 50 year old lady with end stage renal disease, treated with colistin for catheter related blood stream infection and developed muscle weakness and parasthesia. Concomitant use of meropenem may have precipitated neurotoxicity of colistin. Conventional hemodialysis was effective in reversing her signs and symptoms. Clinicians should be aware of the risk of neurotoxicity while using colistin, especially after a loading dose in patients with renal impairment. According to our knowledge, this is the first report of conventional hemodialysis reversing the neurotoxic effects of colistin.

scholarly journals Intracardiac fistula: an unusual complication of catheter-related blood stream infection

JRSM Open ◽  
2017 ◽  
Vol 8 (9) ◽  
pp. 205427041772823 ◽  
Author(s):  
Abhilash Koratala ◽  
Hussain Aboud ◽  
Robert Gibson ◽  
Karen K Hamilton
Keyword(s):  
End Stage Renal Disease ◽  
Blood Stream Infection ◽  
Significant Risk ◽  
Blood Stream ◽  
Unusual Complication ◽  
Early Use ◽  
Venous Fistula ◽  
Stage Renal Disease ◽  
End Stage ◽  
High Index Of Suspicion

Lesson In end stage renal disease patients on dialysis, the use of catheter as a vascular access is associated with a significant risk of sepsis compared to an arterio-venous fistula. Our case emphasizes the importance of having high index of suspicion for unusual complications in patients presenting with possible catheter-related blood stream infection and early use of complementary tools such as trans-oesophageal echocardiography whenever applicable.

A 2% Taurolidine Catheter Lock Solution Prevents Catheter-Related Bloodstream Infection (CRBSI) and Catheter Dysfunction in Hemodialysis Patients

2020 ◽  
Vol 25 (4) ◽  
pp. 48-56
Author(s):  
Matthias Alexander Neusser ◽  
Irina Bobe ◽  
Anne Hammermeister ◽  
Udo Wittmann
Keyword(s):  
Bloodstream Infection ◽  
Hemodialysis Patients ◽  
Catheter Dysfunction ◽  
Lock Solution ◽  
Catheter Lock ◽  
Catheter Related Bloodstream Infection

Highlights 2% Taurolidine catheter lock solution without additives is safe and efficient. CRBSI and dysfunction rates compare favorably against other studies in hemodialysis.

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