The evaluation of catheter infections in kidney disease patients

Yıl 2021, , 69 - 74, 30.01.2021

Pervin Özkan , İbrahim Güney , Suleyman Karakose , Mustafa Topal , Edip Erkuş , Arzu Tarakcı

https://doi.org/10.16899/jcm.734057

Öz

Aim: In our study, we aimed to review the factors retrospectively that may be related to catheter infection (CI) in patients who received hemodialysis (HD) treatment in our clinic and followed up due to CI.
Materials and Methods: The files of 105 patients who were hospitalized in the Nephrology clinic or Intensıve Care Unıt (ICU) and who were diagnosed as CI while on HD treatment were analyzed retrospectively.
Results: Forty-seven (44.8%) of the patients were male, 58 (55.2%) were female and the mean age was 62.3 ± 17.6 (19-90). The average length of hospital stay of the patients was 16 (2-60) days and the infection was mortal in 16 (15.2%) patients. In the cultures taken from the catheters, in 51 (48.6%) patients Gr (+) bacteria, in 24 (22.9%) patients Gr (-) bacteria and in 2 (1.9%) patients fungi were detected. There was no reproduction in 26 (24.8%) catheter cultures. The methicillin resistance (MR) was 87.6% and the highest resistance was detected in Coagulase Negative Staphylococcus (CNS) and S. aureus culture samples. 43 (41.0%) of the patients didn't respond to antibiotics during treatment and catheter exchange was required in these patients. Catheter replacement requirement was significantly higher in the Gr (-) bacterial group (14 patients, 58.3%) (p = 0.050).
Conclusion: To prevent CI, it is important to reveal the factors related to infection. Microbiological agent distribution and resistance rate of each clinic and HD unit are different. Antibiotherapy should be planned according to this agent distribution to decrease antibiotic resistance.

Anahtar Kelimeler

Kidney disease, catheter infections, , gram negative bacteria

Proje Numarası

S. B. Üniversitesi Konya Eğitim ve Araştırma Hastanesi, Şubat ayı TUEK toplantı karar ve sayı no: 06.02.2020 tarih ve 35-35 nolu karar, sayı no 48929119/ 74

Kaynakça

• Referans1 Hemodialysis Adequacy 2006 Work Group. Clinical practice guidelines for hemodialysis adequacy, update 2006. Am J Kidney Dis 2006;48(1):1-10.
• Referans2 Camins BC. Prevention and treatment of hemodialysis related bloodstream infections. Semin Dial 2013;26(4):476-81.
• Referans3 Böhlke M, Uliano G, Barcellos F. Hemodialysis catheter-related infection: prophylaxis, diagnosis and treatment. The J of Vasc Access 2015;16(5):347-55.
• Referans4 Ravani P, Palmer SC, Oliver MJ et al. Associations between hemodialysis access type and clinical outcomes: a systematic review. J Am Soc Nephrol 2013;24(3):465-73.
• Referans5 Raji YR, Ajayi SO, Aminu O et al. Outcomes of tunneled internal jugular venous catheters for chronic haemodialysis at the University College Hospital, Ibadan, Nigeria. Pan Afr Med J 2018;31:218.
• Referans6 Vats HS. Complications of catheters: tunneled and non-tunneled. Adv Chronic Kidney Dis 2012;19(3):188-94.
• Referans7 Fry AC, Stratton J, Farrington K et al. Factors affecting long-term survival of tunneled haemodialysis catheters: a prospective audit of 812 tunneled catheters. Nephrol Dial Transplant 2008;23(1):275- 81.
• Referans8 Centers for Disease Control and Prevention (CDC). Reducing bloodstream infections in an outpatient hemodialysis center New Jersey, 2008-2011. MMWR Morb Mortal Wkly Rep 2012;61(10):169-73.
• Referans9 Alhazmi SM, Noor SO, Alshamrani MM et al. Bloodstream infection at hemodialysis facilities in Jeddah: a medical record review. Ann Saudı Med 2019;9(4):258-64.
• Referans10 Centers for Disease Control and Prevention (CDC). Invasive methicillin resistant Staphylococcus aureus infections among dialysis patients United States, 2005. MMWR Morb Mortal Wkly Rep 2007;56(9):197-9.
• Referans11 Chu C, Wong MY, Tseng YH et al. Vascular access infection by Staphylococcus aureus from removed dialysis accesses. Microbiology Open 2019;8:1-10.
• Referans12 Nguyen DB, Lessa FC, Belflower R et al. Invasive methicillin resistant Staphylococcus aureus infections among patients on chronic dialysis in the United States, 2005-2011. Clin Infect Dis 2013;57(10):1393-400.
• Referans13 Fram D, Okuno MF, Taminato M et al. Risk factors for bloodstream infection in patients at a Brazilian hemodialysis center: a case–control study. BMC Infectious Dis 2015;15:158-65.
• Referans14 Murray EC, Marek A., Thomson PC et al. Gram-negative bacteraemia in haemodialysis. Nephrol Dial Transplant 2015;30:1208–17.
• Referans15 Mermel LA, Allon M, Bouza E et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection 2009 Update by the Infectious Diseases Society of America. Clin Infect Dis 2009;49:1–45.
• Referans16 Ashby DR, Power A, Singh S et al. Bacteremia associated with tunneled hemodialysis catheters: outcome after attempted salvage. Clin J Am Soc Nephrol 2009;4:1601–5.
• Referans17 Al-Hasan MN, Eckel-Passow JE, Baddour LM. Impact of healthcare associated acquisition on community onset Gram-negative bloodstream infection: A population-based study. Eur J Clin Microbiol Infect Dis 2012;31:1163–71.
• Referans18 Girndt M. Bacteraemia in haemodialysis patients-not always Staphylococcus aureus. Nephrol Dial Transplant 2015;30:1055–7.
• Referans19 European Centre for Disease Prevention and Control. Antimicrobial resistance interactive database (EARS-Net) antimicrobial resistance. April 2015
• Referans20 Calfee DP. Multidrug-resistant organisms in dialysis patients. Semin Dial 2013;26:447–56.
• Referans21 Pop-Vicas A, Strom J, Stanley K et al. Multidrug-resistant gram-negative bacteria among patients who require chronic hemodialysis. Clin J Am Soc Nephrol 2008;3:752–8.
• Referans22 Dimopoulos G, Karabinis A, Samonis G et al. Candidemia in immunocompromised and immunocompetent critically ill patients: A prospective comparative study. Eur J Clin Microbiol Infect Dis 2007;26(6):377–84.
• Referans23 Blumberg HM, Jarvis WR, Soucie JM et al. Risk factors for candidal bloodstream infections in surgical intensive care unit patients: The NEMIS prospective multicenter study. The National Epidemiology of Mycosis Survey. Clin Infect Dis 2001;33(2):177–86.
• Referans24 Kargaltseva NM, Kotcherovets VI, Mironov AY et al. Inflammation markers and bloodstream infection (review of literature). Clin Lab Diagn 2019;64(7):435-42.
• Referans25 Zaloga GP, Chernow B. The multifactorial basis for hypocalcemia during sepsis studies of the parathyroid hormone-vitamin D axis. Ann Intern Med 1987;107:36-41.