Evaluation of blood culture results in catheter associated bloodstream infections in hemodialysis patients

Öz

Purpose: Arteriovenous fistula or catheter-related bloodstream infection may develop due to catheter use in patients receiving hemodialysis treatment. This study aims to guide epidemiological data by evaluating blood cultures in patients receiving hemodialysis treatment and developing catheter-related bloodstream infection. Methods: In the present study, hemodialysis patients who were admitted to the hemodialysis unit, nephrology service and intensive care units of Ersin Arslan Training and Research Hospital between January 1, 2021 and February 29, 2024 and Gaziantep City Hospital between October 6, 2023 and February 29, 2024, who were over 18 years of age and who had microorganism growth in blood culture and/or catheter culture were included in the study. A total of 160 catheter-associated bloodstream infection episodes from 102 patients were retrospectively evaluated. Results: Of the 160 infection episodes included in this study, Gram-positive bacteria were isolated in 61.2%, Gram-negative bacteria in 33.8% and Candida species in 5%. Distribution of causative microorganisms was as fallows; Staphylococcus aureus in 45 (28.1%), Coagulase Negative Staphylococcus (CNS) in 38 (23.8%), Klebsiella pneumoniae in 18 (11.3%), Acinetobacter baumanni in 11 (6.9%), Escherichia coli in 9 (5.6%). Methicillin resistance was 37.2% in Staphylococcus aureus and 42.1% in CNS. Carbapenem resistance was 54.5% in Acinetobacter baumanni, 33.3% in Klebsiella pneumoniae and 22.2% in Escherichia coli, respectively. Conclusions: Identifying the causative microorganism of catheter-related bloodstream infections in hemodialysis patients and monitoring antibiotic resistance rates may shed light on empirical treatment selection, contributing to the development of better strategies for infection management and optimization of treatment.

Anahtar Kelimeler

• Hemodialysis
• catheter-associated bloodstream infection
• antibiotic resistance

Hemodiyaliz hastalarında kateter ilişkili kan dolaşımı enfeksiyonlarında kan kültürü sonuçlarının değerlendirilmesi

Öz

Amaç: Hemodiyaliz tedavisi alan hastalarda arteriyovenöz fistül veya kateter kullanımına bağlı kateter ilişkili kan dolaşım enfeksiyonu gelişebilmektedir. Bu çalışmada, hemodiyaliz tedavisi alan ve kateter ilişkili kan dolaşımı enfeksiyonu gelişen hastalarda kan kültürlerinin değerlendirilerek epidemiyolojik verilere rehberlik edilmesi amaçlanmaktadır. Yöntem: Bu çalışmada 1 Ocak 2021 – 29 Şubat 2024 tarihleri arasında Dr. Ersin Arslan Eğitim ve Araştırma Hastanesi ve 6 Ekim 2023 – 29 Şubat 2024 tarihleri arasında Gaziantep Şehir Hastanesi’nde hemodiyaliz ünitesi, nefroloji servisi ve yoğun bakım ünitelerine başvuran, 18 yaş üstü olan ve kan kültürü ve/veya kateter kültüründe mikroorganizma üremesi saptanan hemodiyaliz hastaları çalışmaya dahil edildi. 102 hastadan alınan 160 kateter ilişkili kan dolaşımı enfeksiyon epizodu retrospektif olarak değerlendirildi. Bulgular: Çalışmaya dahil edilen 160 enfeksiyon epizodunun %61,2’ünde Gram pozitif bakteriler, %33,8'inde Gram negatif bakteriler ve %5’inden Candida türleri izole edildi. Etken mikroorganizmaların dağılımı; 45’inde (%28,1) Staphylococcus aureus, 38’inde (%23,8) koagülaz negatif stafilokok (KNS), 18’inde (%11,3) Klebsiella pneumoniae, 11’inde (%6,9) Acinetobacter baumanni, 9’unda (%5,6) Escherichia coli şeklindeydi. Metisilin direnci S. aureus’ta %37,2 iken KNS’de %42,1 idi. Karbapenem direnci sırasıyla A. baumanni’de %54,5, K.pneumoniae’de %33,3, E.coli’de %22,2 şeklindeydi. Sonuç: Hemodiyaliz hastalarında, kateter ilişkili kan dolaşımı enfeksiyonlarında etken mikroorganizmanın tanımlanması ve antibiyotik direnç oranlarının takip edilmesi ampirik tedavi seçimine ışık tutarak, enfeksiyon yönetimi için daha iyi stratejilerin geliştirilmesine ve tedavinin optimize edilmesine katkı sağlayabilir.

Anahtar Kelimeler

• Hemodiyaliz
• kateter ilişkili kan dolaşımı enfeksiyonu
• antibiyotik direnci

Kaynakça

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