Epidemiology of Central Venous Catheters Infection in Hemodialysis Patients

Abstract

Background: Vascular access infections in hemodialysis patients increase by 2-3 folds in central venous catheters compared to arteriovenous fistula or graft. Among these infections exit site infections, tunnel infections and catheter- related bloodstream infections (CRBSI), are the most common complications. CRBSIs are major risk of hospitalization as well as mortality in hemodialysis patients. Objective: To study the epidemiology of central venous catheter related infections (CVC-RI), patterns of microbial infections and antibiotic sensitivity among our hemodialysis patients. Patients and methods: 94 ESRD patients on hemodialysis with temporary central venous catheter (CVC) inserted for more than 48 hours, monitored for the development of CVC related infections (CVC-RI) and divided into two main groups according to presence of catheter infection; (A) non-infected catheter patients and group (B) infected catheter patients Results: The rate of CVC-RI is high in our hemodialysis patients (42.5 %). There was a significant difference between the two studied groups as regard duration of HD and catheterization duration. Patients with evident catheter infections had significantly higher total leucocytic count (TLC) and C-reactive protein (CRP) values. There was a significant positive correlation between CRP with catheter duration and TLC. Staphylococcus aureus was the most prevalent isolated bacteria. Vancomycin was the most common used antibiotic among infected patients. Conclusion: CVC-RI rate is high in our hemodialysis patients (42.5 %). Prolonged duration of CVC usage and diabetes are major risk factors related to infections. Both S. aureus and Gram-negative micro-organisms were the most common organisms found in our study. Vancomycin and imipenem were the most common effective antibiotics according to our blood cultures.