Central Venous Catheter Related Infection among Patients on Hemodialysis

Document Type : Research Paper

Authors

1 Associate Professor of Infectious Disease, Mashhad University of medical sciences, Mashhad, Iran

2 Resident of Infectious Disease, Mashhad University of medical sciences, Mashhad, Iran

Abstract

Introduction:
End Stage Renal Disease (ESRD) patients need vascular access for hemodialysis and infection is the most common late complication of central venous catheters.
Materials and Methods
A descriptive prospective study was done on hemodialysis patients to evaluate the prevalence of the catheter-related infections. Patients with possible central venous catheter infection were enrolled from July 2009 to April 2011 at Imam Reza Hospital, Mashhad. We checked the apparent exit site infection as well as the systemic signs and symptoms of catheter-related infection. Specimens were obtained from the catheter blood, the catheter tip and the peripheral blood for culture and antibiogram. Then data was collected by using SPSS. Frequency tables, graphs and mean were prepared for describing data.
Results
From total 65 hemodialysis patients (34 females, 31 males with a mean age of 54.9), 41 ones (63/1%) had a past history of catheter-related infection. As for the local signs of infection, 52 patients (80%) had tenderness, 41 (63.1%) had induration, 35 (53.8%) had redness and 32 ones (49.2%) had pus discharge from the catheter insertion site. Staphylococcus aureus was the prevalent organism among 76.7% of patients with positive culture out of which 79.6% were vancomycin sensitive. Catheter had to be removed in 21(33.3%) of the dialysis patients.
Conclusion
Staphylococcus aureus was the most common organism involving in catheter-related infection among hemodialysis patients and the most common clinical sign of infection, was tenderness at the catheter insertion site. We suggest that these findings could be used for early diagnosis and starting the empiric antibiotic regimen in patients with central venous catheters.

Keywords

References

1. Betjes MG. Prevention of catheter-related blood stream infection in patients on hemodialysis. Not Rev Nephrol 2011;
7:257-265.
2. Beekmann SE, Henderson DK. Infections caused by percutaneous intravascular devices. In: Mandell GL, Bennett JE,
Dolin R. Principles and practice of infectious Disease. 7th ed. Churchill Livingstone Elsevier; 2010.p.3697-3716.
3. Goede MR, Coopersmith CM. Catheter – related bloodstream infection. Surg Clin N Am 2009; 89:463-474.
4. Ghane Sherbaf F. A comparison between complication of central venous catheter & arterio venous fistula in children
under chronic hemodialysis. J Iran Child Dis 2006; 16:407-412. [Persian]
5. Lee Sc, Chen KS. An outbreak of methicillin – resistant staphylococcus aureus infectious related to central venous
catheter for hemodialysis. Infect Control Hosp Epidemiol 2004; 25:678-684.
6. Hoen B, Kessler M. Risk factors for bacterial infections in chronic hemodialysis adult patients: a multicenter
prospective survey. Nephrol Dal Transplant 1995; 10:377-381.
7. Jean G. Incidence and risk factors for infectious from hemodialysis catheters. Nephrologie 2001; 22:443-448.
8. Clarke A, Bell J. Preventing central venous catheter Related – Blood stream Infections : Victorian Government
Health Information safer systems saving lives 200.
9. Hung KY, Tsai TJ. Infection associated with double lumen catheterization for temporary hemodialysis: experience
of 168 cases. Nephron Dail Transplant 1995; 10:247-251.
 
medical journal of mashhad university of medical sciences
Volume 55, Issue 2 - Serial Number 2
May and June 2012
Pages 110-115

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