#3139 PREVALENCE OF INFECTIONS ASSOCIATED WITH THE HEMODIALYSIS CATHETER IN MEXICO CITY

Abstract

Abstract Background and Aims In hemodialysis, intravenous catheter is the most frequent vascular access to begin treatment in patients with chronic kidney disease. Infectious complications are a frequent adverse effect of the vascular access, they may cause vascular access retreat and serious diseases like septic shock, bacterial endocarditis, septic arthritis, venous thromboembolism and death (between 5 and 10%). Leading microorganisms of hemodialysis infection are Gram positive bacteria, while Gram negative are less common. Method Study type and design: Used a descriptive, retrospective, open, observational and analytical cross-sectional study. Sampling type: Non-probabilistic of consecutive cases. Population: Patients diagnosed with CKD 5 KDIGO on renal function replacement therapy with hemodialysis through a temporary or permanent catheter in a private kidney care unit in Mexico City from October 2014 to September 2022. Results We identified 168 cases of CRBSI throughout the 8 years of the study. We found a prevalence of 0.86% for every 100 hemodialysis and a cumulative incidence of 4.97% for every 100 hemodialysis. Leading etiology pathogens of CRBSI in the kidney care unit were Gram negative bacteria (76.8%), mainly Enterobacter cloacae (20.8%), Escherichia coli (13.7%), Stenotrophomonas maltophilia (11.9%) and Burkholderia cepacia (4.2%). We found that 51,8% of the Gram negative CRBSI were due to multiresistant bacteria, which led to 5 directly related deaths. On the other hand, Gram positive bacteria caused 23.2% of CRBSI. Staphylococcus aureus and Staphylococcus epidermidis were the most frequent with 8.9% and 8.3%, respectively, with no related deaths. Conclusion Unlike international literature, in our study, gram negative bacteria were the main agents of CRBSI. The prevalence of CRBSI in our study was high, however, infection directly related mortality remained low. These results led us to investigate the origin of the vascular access infection. In an attempt to reduce the number of CRBSI, we emphasized preventive measures, especially hand hygiene of healthcare professionals within the kidney care unit and with the patient's personal environment at home. We would like to recall that empirical therapy should be based on the results of the kidney care unit microbiology and antibiotic sensitivity, to reduce CRBSI episodes and bacterial resistance.