#2913 BLOODSTREAM INFECTIONS IN CHRONIC HEMODIALYSIS PATIENTS: CHARACTERISTICS AND OUTCOMES

Abstract

Abstract Background and Aims Bloodstream Infections (BSI) are a major cause of death and hospitalization among hemodialysis (HD) patients. In recent years several preventive measures were introduced to reduce BSI in HD patients. Despite these various strategies, the rate of BSI in HD remains high. The aim of the present study was to explore factors associated with BSI in a contemporary cohort of HD patients at a public teaching hospital dialysis center. Method This was a retrospective cohort study of HD patients with a BSI in the years 2014 to 2018. The cohort included patients aged ≥ 18 years treated with chronic HD for at least three months. The primary outcome was the occurrence of BSI. We examined the clinical characteristics of the patients, causative pathogens, and mortality. Results The study involved 251 chronic HD patients. The mean age was 68.5±13.4 years, 69.9% were male. The most frequent cause of end-stage renal disease was diabetes (46.7% of patients). The mean time from initiation of HD was 34.8±40.8 months and the follow up period was 25.2±15.9 months. During the observation period, 44 patients (17.5%) developed 54 BSI events, while 9 of them (3.6% of the whole cohort) developed recurrent BSI events. Gram-negative microorganisms caused 46.3% of all BSI events. 31.4% of these BSI were caused by resistant bacteria. In multivariate logistic regression analysis, factors that increased the risk of mortality were BSI events (OR 2.566, p = 0.035), patients' age (OR 1.068, p<0.001), diabetes (OR 1.019, p = 0.001). Conclusion We noted an increased prevalence of gram-negative pathogens in the etiology of BSI in HD patients. Our findings highlight the need to be aware of local epidemiology in order to implement appropriate preventative measures and tailor empiric antibiotic therapy.