Abstract
A multicenter prospective surveillance on dialysis events was carried in 33 dialysis centers in China. Maintenance hemodialysis (HD) outpatients who were dialyzed on the first two days of each month during 2014 were monitored for dialysis events and other infections. During the one-year period, 52,680 patient-months were monitored. Fistula and tunneled or non-tunneled central line were used for 73.70%, 15.70% and 8.85% of vascular access, respectively. There were 773 dialysis events occurred in 671 patients including 589 IV antimicrobial starts, 74 positive blood cultures and 110 local access site infections (LASI). The incidence of dialysis events was 1.47 per 100 patient-months. Among the 74 cases with bloodstream infection (BSI), 38 were access-related BSI (ARB) and there were therefore 148 cases with vascular-related infection (VAI; 38 ARB and 110 LASI). There were 740 cases (1.40 per 100 patient-months) with infections other than BSI and LASI, most (79.19%) of which were respiratory tract infections. For those with dialysis events, there were 425 cases (425/671, 63.34%) admitted to hospital and 12 cases of death (12/671, 1.79%). In conclusion, the surveillance revealed a relatively low incidence of dialysis events and the surveillance may be tailored to target those using central lines in resource-limited settings.
Highlights
According to the data that Chinese Hospital Association collected from dialysis centers, the prevalence of end stage renal diseases in China was 79.1 million in 20081
The National Healthcare Safety Network (NHSN) of the Center of Disease Prevention and Control (CDC) has developed a protocol for surveillance on several types of infection-related adverse events associated with HD called dialysis events[14], which has the potential to be adopted or adapted for monitoring patients in China
A total of 773 dialysis events occurred in 671 cases and the overall incidence of dialysis events was 1.47 per 100 patient-months (773/52,680) during the surveillance period
Summary
According to the data that Chinese Hospital Association collected from dialysis centers, the prevalence of end stage renal diseases in China was 79.1 million in 20081. BSI and localized infections of the vascular access site cause substantial morbidity and mortality in HD patients[9, 10]. Both the American Center of Disease Prevention and Control (CDC) and the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI) recommend monitoring infections in dialysis patients[11, 12]. The National Healthcare Safety Network (NHSN) of the CDC has developed a protocol for surveillance on several types of infection-related adverse events associated with HD called dialysis events[14], which has the potential to be adopted or adapted for monitoring patients in China. We performed a prospective multi-center surveillance to investigate the incidence and the spectrum of dialysis events among HD outpatients in China, which is reported here
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