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 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 Frequency and Microbiological Profile of Catheter-Related Infections in Hemodialysis Patients Receiving Gentamicin as Antimicrobial Lock Therapy for Prophylaxis

2021 ◽  
Vol 4 (03) ◽  
Author(s):  
Sumbal Nasir Mahmood ◽  
Sabaa Asif ◽  
Muhammad Amim Anwar ◽  
Osama Kunwer Naveed
Keyword(s):  
Blood Culture ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Cross Sectional Study ◽  
Immunosuppressive Drugs ◽  
Hemodialysis Patients ◽  
Exit Site ◽  
Cross Sectional ◽  
Exit Site Infection ◽  
Antibiotic Lock

Antibiotic lock solution (ALS) in the lumen of catheter is a mean to decrease the possibility of catheter related blood stream infection (CRBSI). We conducted this study using Gentamicin as ALS to observe the frequency of catheter related infections (CRI) including CRBSI and exit site infection in this hemodialysis patients being dialyzed through tunneled and temporary hemodialysis catheters. Methods This descriptive, cross sectional study was conducted at Dr. Ziauddin Hospital, North Campus between January 2017- December 2017. Symptomatic patients for CRBSI were included in this study. Blood culture from the catheter ports and periphery and exit site swab if pus visible were sent for culture sensitivity.  Results Total 138 patients of either gender with age more than 18 years to less than 80 years were evaluated. 44.9% were male and mean age of patients was 58.79±14.05 years. 70.3% patients were diabetic for 15.61±4.61 years and 11.6% were using immunosuppressive drugs. The overall mean catheter duration was 22.27±14.39 days and mean hemodialysis duration was 25.32±44.31 weeks. Tunneled catheter was placed in 40.6% and 46.4% had femoral temporary catheters. Blood culture was done for 51 cases and 21.5% were positive. Tip culture was positive in 33.3% patients. In our study, 23.18% patients were found to have catheter related infections, out of which 61.5% were found with gentamicin resistance including colonization. Conclusion We report a high frequency of catheter related infections despite using ALS as prophylaxis, with predominant organisms being gram positives and a high incidence of gentamycin resistance.

scholarly journals Hemodialysis Catheter-Related Infection in a Teaching Hospital of Central Nepal

2019 ◽  
Vol 41 (2) ◽  
pp. 11-16
Author(s):  
Arun Sedhain ◽  
Abja Sapkota ◽  
Narayan B Mahotra
Keyword(s):  
Risk Factors ◽  
Blood Stream Infection ◽  
Antibiotic Sensitivity ◽  
Major Complication ◽  
Venous Catheter ◽  
Blood Stream ◽  
Recent Change ◽  
Catheter Related Infection ◽  
Hemodialysis Catheter ◽  
A Prospective Study

Introduction: Infection of the central venous catheter (CVC) is a major complication seen among patients undergoing hemodialysis. Identifying CVC related infection (CRI) and its risk factors and causative organisms is important for better implementation of preventive strategies. Methods: A prospective study was conducted at Chitwan Medical College for duration of 2 years from January 2017to December 2018 among the patients undergoing hemodialysis via CVC. The data collected were related to patients’ demographics, site of catheter insertion, and duration, microbiological data including cultures from catheter sites, blood, and catheters’ tips and antibiotic sensitivity. Catheter related infection was divided into catheter related local infection (CRLI) and catheter related blood stream infection (CRBSI). Data was analyzed using IBM SPSS Statistics version 21.0. Results: A total of 41 cases of CVC related infection (CRI) were documented with an incidence rate of 6.94 episodes per 1000 catheter days at risk. Out of the total CRI, 39.02% were CRLI and 60.98% were CRBSI. Fever with chills and rigor were the most common clinical presentation. Risk factors for the development of CRI were duration of catheter in situ, repeated change of CVC and the use of CVC for indications other than hemodialysis (HD).Staphylococci and Klebsiella were the most common organisms isolated in culture. Conclusion: The rate of CRI among Nepalese patients undergoing hemodialysis is high. Prolonged duration of CVC usage, recent change of catheter and the use of the HD catheter for the purpose of institution of intravenous medication have been found as the risk factors for CRI.

scholarly journals The Impact of the Introduction of Innovative REDS Scale for the Evaluation of Central Tunnelled Catheter (CTC) Exit Site on Infection Prevention in Long-Term Haemodialyzed Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Tomasz Porazko ◽  
Edyta Stasiak ◽  
Marian Klinger
Keyword(s):  
Blood Stream Infection ◽  
Bloodstream Infections ◽  
Cost Effective ◽  
Blood Stream ◽  
Site Infection ◽  
Exit Site ◽  
Exit Site Infection ◽  
The Impact

Central tunneled catheter (CTC)-related infections are a leading cause of a catheter loss, thus being the source of significant morbidity and mortality. The study aims at evaluating the impact of the implementation of the innovative redness, edema, discharge and tenderness, symptoms (REDS) scale (devised by the authors) for the description of the tunnel condition on the frequency of infection in long-term catheter users. The same cohort of the 40 patients was observed for 4 years altogether: 2 years before and 2 years after REDS application. The results, as well as follow-up evaluation of participants, were compared. The 2-year cumulative incidence of the CTC exit site infection (ESI) dropped significantly (log-rank p < 0.001) from 0.89 episode/1,000 catheter days (53.5%, 95% CI [35.9%; 66.2%]) in the period before REDS was used—to 0.26 episode/1,000 catheter days (18.6%, 95% CI [6.1%; 29.4%]) in the time of REDS application. There were also significantly fewer episodes of ESI complicated with catheter-related blood stream infection (CRBSI) requiring the CTC removal (0.6 episode/1,000 catheter days; 18.6%, 95% CI [6.1%; 29.4%] vs. 0.3 episode/1,000 catheter days; 4.7%, 95% CI [0.0; 10.7%]; log-rank p = 0.04, in pre-REDS and REDS time, respectively). The REDS scale appears to be a simple, cost-effective tool reducing the frequency of the tunneled CTC exit site infection and associated bloodstream infections.

scholarly journals Antibiotic Resistant Bacterial Pathogens Associated with Blood Stream Infections and Urinary Tract Infections among Intensive Care Unit Patients

2020 ◽  
Vol 14 (3) ◽  
pp. 1737-1748
Author(s):  
Shriram Dorairaj Gunasekaran ◽  
Godfred Antony Menezes ◽  
Rezmitha Zulfihar Nazeem ◽  
Mohammad Obada Sultan ◽  
Tejaswini Archarya ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Bacterial Resistance ◽  
Blood Stream Infection ◽  
Age Groups ◽  
Blood Stream ◽  
Morbidity And Mortality ◽  
Antibiotic Resistant ◽  
Rapid Spread ◽  
Tract Infections ◽  
Microbiological Data

Blood Stream Infection (BSI) and Urinary Tract Infection (UTI) being leading causes of morbidity and mortality represent a common complication among critically ill patients. During the last decade, clinicians have observed a rising occurrence of BSIs due to bacterial resistance. Likewise, catheter-associated UTI is a main cause of morbidity and mortality affecting all age groups. Coliforms happen to be the prominent pathogens among our ICU admitted patients. It was alarming to notice 42.9% resistance to tigecycline among K. pneumoniae isolated from blood. K. pneumoniae isolates cultured from urine of ICU patients uniformly displayed 75% resistance to ciprofloxacin, ceftriaxone, cefoxitin and cefepime. Interestingly, it is of respite to observe 85.7% K. pneumoniae isolated from blood and 75% K. pneumoniae isolated from urine being susceptible to a conventional antibiotic, gentamicin. Escherichia coli isolated from urine were 100% susceptible to carbapenems and 91.75% were susceptible to tigecycline. Overall, 90% of Pseudomonas aeruginosa were susceptible to nitrofurantoin. The rapid spread of these MDR pathogens demands for national and regional guidelines. Policies to treat ICU related infections in UAE should be designed based on local microbiological data and resistance profiles of pathogens.

scholarly journals Study of sepsis and its markers in renal failure patients on hemodialysis

2021 ◽  
Author(s):  
Prachi Dubey ◽  
Sanjay Varma ◽  
Bhuwan Sharma
Keyword(s):  
Risk Factors ◽  
Renal Failure ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
P Value ◽  
Radiological Investigation ◽  
Hemodialysis Catheter ◽  
Prolonged Duration ◽  
History Of ◽  
Rule Out

Background: Patients with chronic kidney disease have impaired immunity due to disease per se and because of immunosuppressant treatment used for their disease. Catheters used for hemodialysis acts as conduit for microorganisms to cause infections. This leads to increase in morbidity and mortality.Methods: 100 patients of renal failure requiring hemodialysis were selected. Relevant pathological and radiological investigation done to rule out already existing infection, later on tests were repeated after catheter insertion and hemodialysis to check for infection and sepsis. Using appropriate statistical analysis was done and p value <0.05 was taken as significant.Results: Out of 100 patients underwent study, 15 developed catheter related blood stream infection. Older age, history of diabetes, male sex, diabetes, anemia, hypoalbuminemia, hyperphosphatemia, prolonged duration of hemodialysis and site of hemodialysis catheter were found to be risk factor for infection.Conclusions: Patients requiring hemodialysis, who are having non modifiable risk factors like age, sex other risk factors for infection should be controlled to reduce incidence of infection. 

scholarly journals Salvage of Hemodialysis Catheter in Staphylococcal Bacteremia: Case Series, Revisiting the Literature, and the Role of the Pharmacist

2018 ◽  
Vol 8 (2) ◽  
pp. 121-129 ◽  
Author(s):  
Wasim S. El Nekidy ◽  
Derrick Soong ◽  
Albert Kadri ◽  
Osama Tabbara ◽  
Amina Ibrahim ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Case Series ◽  
Blood Stream ◽  
Hemodialysis Patients ◽  
Vascular Trauma ◽  
Central Vein ◽  
Hemodialysis Catheter ◽  
Lock Solution ◽  
Antibiotic Lock ◽  
Systemic Antibiotics

Catheter-related blood stream infections comprise a major concern in hemodialysis patients, leading to increased mortality, morbidity, and cost of treatment. Prompt appropriate systemic antibiotics treatment, which includes administration of appropriate systemic antibiotics and, frequently, catheter removal and replacement, is warranted. However, in hemodialysis patients, repeated catheter insertions may cause central vein stenosis and thrombosis which limits the future availability of hemodialysis access. Lock solutions containing antibiotics and anticoagulants, instilled directly into the catheter lumen after each dialysis, have been successfully utilized for catheter salvage but higher rates of recurrence and complications were observed in infections resulting from staphylococcal species. We report several cases of catheter salvage using antibiotic lock solution in staphylococcal bacteremia with the purpose of stimulating the interest in randomized clinical trials. Evaluating the risk and benefits of catheter salvage in this patient subset in light of optimized systemic antibiotic dosing, improved lock solution use, and multidisciplinary involvement, balanced with the critical need to prevent unnecessary vascular trauma, is of great importance.

Tunneled hemodialysis catheter care practices and blood stream infection rate in children: results from the SCOPE collaborative

2019 ◽  
Vol 35 (1) ◽  
pp. 135-143
Author(s):  
Olivera Marsenic ◽  
◽  
Jonathan Rodean ◽  
Troy Richardson ◽  
Sarah Swartz ◽  
...  
Keyword(s):  
Infection Rate ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Hemodialysis Catheter ◽  
Care Practices ◽  
Catheter Care
Sign in / Sign up

Export Citation Format

Share Document