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Factors Involved in Cuffed Catheter-Related Infections in Hemodialysis Patients

AUTHORS

Amer A Al-Kinani 1 , Fayez Hejaili 1 , Ahmed Flaiw 1 , Salim Qurashi 1 , Ghormullah Ghamdi 1 , Ibtesam Mahmoud 1 , Abdullah Al-Sayyari 2 , *

1 King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia

2 Departement of Medicine, King Saud Bin Abdulaziz University for Health Sciences, aaalsayyari@gmail.com, Saudi Arabia

How to Cite: Al-Kinani A, Hejaili F, Flaiw A, Qurashi S, Ghamdi G, et al. Factors Involved in Cuffed Catheter-Related Infections in Hemodialysis Patients, Nephro-Urol Mon. Online ahead of Print ; 3(1):34-40.

ARTICLE INFORMATION

Nephro-Urology Monthly: 3 (1); 34-40
Article Type: Research Article
Received: March 14, 2010
Accepted: April 8, 2010

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Abstract

Background and Aims: Dialysis catheter-related infections (CRI) remain a significant cause for morbidity and mortality in hemodialysis patients. We studied factors that predispose hemodialysis patients to CRI.

Methods: This a retrospective case controlled study of hemodialysis patients with a cuffed permanent catheter access conducted over a 12-month period. Those developing CRI acted as the study group and those who remained free of CRI acted as controls.

Patients and catheter variables that were documented included: Chronic Comorbidity Index (CCI), serum albumin level, Kt/V, number of CRI, organism/s isolated, and whether the catheter had to be removed. Significance of differences between the two groups was assessed using two tailed independent test for continuous variables and Chi square for categorical variables.

Results: Fifty-seven study patients and 39 controls were included. There were 107 episodes CRIs. The number of episodes of infection/catheter patients was 1.1 after a mean follow up period of 933 (± 255) days. Number of episodes of infection per 1000 catheter/days was 1.2 and per 100 dialysis sessions was 0.714.

Catheter duration was shorter (1040 ± 198 days) in the infected group compared to the control group (1139 ± 275 days, p=0.042). The commonest organism isolated was Staph aureus (35%) followed by Enterobacter cloacae (14.8%). The commonest antibiotic used was vancomycin, followed by gentamycin and ceftazidime. The actuarial catheter survival was markedly less with multiple episodes of infection compared to single episode (p=0.029). A single episode of infection was associated with 9.5% chance of catheter losses as opposed to a 43.3% chance in multiple infections (p=0.0001).

Conclusions: Risk of infection was increased with femoral placement and number of dialysis sessions. The risk of catheter loss with multiple infections is more. The demographic characteristics are not a risk factor for developing infection.

Keywords

Infection Dialysis catheter Hemodialysis

© 0, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

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