Risk Factors for Catheter-related Infections in Patients Receiving Permanent Dialysis Catheter

Overview

Journal BMC Nephrol

Publisher Biomed Central

Specialty Nephrology

Date 2019 Jun 2

PMID 31151433

Citations 13

Authors

Fani Delistefani

Manuel Wallbach

Gerhard A Muller

Michael J Koziolek

Clemens Grupp

Affiliations

Soon will be listed here.

Abstract

Background: Due to rising vascular comorbidities of patients undergoing dialysis, the prevalence of permanent hemodialysis catheters as hemodialysis access is increasing. However, infection is a major complication of these catheters. Therefore, identification of potential predicting risk factors leading to early infection related complications is valuable, in particular the significance the CRP (C-reactive protein)-value is of interest.

Methods: In this retrospective study 151 permanent hemodialysis catheters implanted in 130 patients were examined. The following data were collected at the time of catheter implantation: CRP-value, history of catheter-related infection, microbiological status, immunosuppression and diabetes mellitus. The primary outcomes were recorded over the 3 months following the implantation: catheter-related infection, days of hospital stay and death. Catheter removal or revision, rehospitalization and use of antibiotics were identified as secondary outcomes.

Results: We identified a total of 27 (17.9%) infections (systemic infection: 2.26 episodes/ 1000 catheter days, local infection: 0.6 episodes/ 1000 catheter days). The development of an infection was independent of the CRP-value (p = 0.66) as well as the presence of diabetes mellitus (p = 0.64) or immunosuppression (p = 0.71). Univariate analysis revealed that infection was more frequent in patients with MRSA-carriage (p < 0.001), in case of previous catheter-related infection (p < 0.05) and of bacteremia or bacteriuria in the period of 3 months before catheter implantation (p < 0.001). Catheter removal or revision (p = 0.002), rehospitalization (p = 0.001) and use of antibiotics (p = 0.02) were also more often observed in patients with MRSA-carriage.

Conclusions: The CRP-value at the time of implantation of a permanent hemodialysis catheter is not associated with the development of early catheter related infections, but an individual history of catheter-related infection, MRSA-carriage and bacteremia or bacteriuria in the period of 3 months prior to catheter implantation are significant risk factors.

Citing Articles

Incidence, Risk Factors, Organism Types, and Outcomes of Catheter-Related Bloodstream Infections in Hemodialysis Patients.

Bitunguramye A, Nkundimana G, Aboubasha A, Kabahizi J, Rutikanga W, Nshimiyimana L Cureus. 2024; 16(9):e69554.

PMID: 39291254 PMC: 11406115. DOI: 10.7759/cureus.69554.

Non-tunneled haemodialysis catheter-related blood stream infections and associated factors among first time haemodialysis patients: a prospective study from a tertiary care hospital in Sri Lanka.

Muthukuda C, Suriyakumara V, Samarathunga T, Liyanage L, Marasinghe A BMC Nephrol. 2024; 25(1):280.

PMID: 39198819 PMC: 11361233. DOI: 10.1186/s12882-024-03726-4.

The evolving panorama of vascular access in the 21st century.

Neyra N, Wazir S Front Nephrol. 2023; 2:917265.

PMID: 37675010 PMC: 10479615. DOI: 10.3389/fneph.2022.917265.

Ratio of Extracellular to Intracellular Water Is Associated with Permanent Catheter Patency Survival in Patients Receiving Maintenance Hemodialysis.

Kim M, Jeon J, Kim H, Park H, Han S, Hwang Y Diagnostics (Basel). 2023; 13(15).

PMID: 37568908 PMC: 10417513. DOI: 10.3390/diagnostics13152545.

Characterization of the Human Blood Virome in Iranian Multiple Transfused Patients.

Thijssen M, Khamisipour G, Maleki M, Devos T, Li G, Van Ranst M Viruses. 2023; 15(7).

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