Infection In Hemodialysis Patients Research Articles

Frequency of Hepatitis B and C Infections in Haemodialysis Patients

Background: Hepatitis B (HBV), and Hepatitis C viral HCV) infections are the major health problems worldwide. Patients undergoing hemodialysis (HD) are more vulnerable to acquired such infections than the general population. Objective: To evaluate the prevalence of HBV and HCV infection in hemodialysis patients and the association of number of dialysis and history of blood transfusion with risk of HBsAg and HCV infection. Methods: This cross-sectional observational study was conducted in inpatient and outpatient department of Nephrology and Medicine, Rangpur Medical College and Hospital, Rangpur, Bangladesh from December 2021 to May 2022. A total of 80 diagnosed case of End Stage Renal Disease (ESRD), who underwent dialysis during the study period were included in the study. Complete history was taken either from patient or accompanying attendants. Collected data were classified, edited, coded and entered the computer for statistical analysis by using SPSS version 23. Results: Out of 80 hemodialysis patients, mean age was found 42.6±8.6 years with range from 21 to 59 years. Male patients were predominant (72.50%) with male to female ratio was 2.6:1. The prevalence of HBV and HCV infection was found in 8.75% and 11.25% respectively. Frequency of dialysis and history of blood transfusion was not significantly associated with risk of HBsAg and HCV infection. Conclusion: The prevalence of HBV and HCV infection was found in 8.75% and 11.25% respectively. Frequency of dialysis and history of blood transfusion was not significantly associated with risk of HBsAg and HCV infection. J Rang Med Col. September 2024; Vol. 9, No. 2: 72-77

Correlation of Interleukin-10 and Interleukin-8 with Cytomegalovirus and Epstein–Barr Virus Infection in Hemodialysis Patients

Abstract Background: Herpes viruses like cytomegalovirus (CMV) and Epstein–Barr virus (EBV) can cause serious illness in those who already have impaired immune systems. Objectives: The purpose of this research was to examine the impact of CMV and EBV infection on specific immunological markers in individuals undergoing hemodialysis. Materials and Methods: Blood sample was collected from 91 hemodialysis patients and 50 healthy individuals as a control group for comparison. Serum was separated and examined for the confirmation of CMV and EBV infection, and then the sera was tested by using specific ELISA kits (human interleukin-10 and human IL-8, Sunlong Biotech Co., HangZhou, China). Results: Highest mean of IL-8 and IL-10 was obtained in CMV IgM positive patients in comparison with IgG positive and control group with P value = 0.00002, 0.0008, respectively. The results in patients with EBV IgM positive were also highly significant in comparison with control, P value for IL-8 was 0.0002 and for IL-10 was 0.00004. Conclusion: The study concluded that, the level of IL-10 and IL-8 was higher among hemodialysis patients with acute EBV and CMV infection, and this indicated that the ability of CMV and EBV to enhance IL-8 and IL-10 production which may play an important role in immune inflammatory states associated with CMV and EBV infection.

Involvement of healthcare staff in hospital hygiene during emergency hemodialysis.

Healthcare-associated infections are still a worrying health problem that complicates patient care and increases morbidity and mortality. The incidence of infections in hemodialysis patients is still high and they constitute the second cause of hospitalization and death in this category. The study's objective was to evaluate nursing and medical staff's involvement in hospital hygiene. This is an observational study that took place within the hemodialysis unit of a Moroccan university hospital from March 2021 to June 2021. A surface swabbing technique for bacteriological examination was also carried out. The study revealed some shortcomings regarding hand hygiene which was respected by the nurses in only 17.5% of sessions and in 42.2% by the doctors. Other shortcomings in asepsis measures, were also noted such as the non-change of gloves after skin preparation (1.03%) and before manual compression. The serological status of patients concerning HBV, HVC, and HIV was also not always known (31.1%). The bacteriological samples from the surfaces also showed colonization of the medical devices and the ultrasound scanner used for the ultrasound-guided introduction of the central catheters. The results of the study showed some deviations concerning the recommendations; however, they are comparable to other studies conducted internationally, especially in terms of hand hygiene. Our study results highlight some shortcomings adherence to hygiene measures like inconsistent disinfection of medical devices and dialysis stations, as well as insufficient hand hygiene practices among some staff members. However, we observed an improvement in practices following the implementation of awareness-raising sessions. To maintain improved hygiene practices and prevent infections, it is crucial to provide ongoing training for staff, ensure adequate resources, and regularly monitor compliance with hygiene standards.

The Association Between Hypoalbuminemia and Catheter-Related Infections in Hemodialysis Patients

Background: Catheter-related infections cause significant complications in patients with end-stage kidney disease (ESKD) undergoing hemodialysis (HD). Objectives: This study aimed to evaluate the association between serum albumin level and catheter-related infection in HD patients. Methods: This study included 210 HD patients with positive blood and catheter cultures and 210 without catheter infection. Mean albumin level, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were also checked as surrogate disease markers and compared between the two groups. Results: Staphylococcus aureus (38.6% of cases) and Staphylococcus epidermidis (27.6% of cases) were the most frequently detected bacteria. Erythrocyte sedimentation rate and CRP were significantly higher in the target group (P = 0.002 and P = 0.001, respectively). Conclusions: In this investigation, hypoalbuminemia did not emerge as an independent risk factor for access-related infections. S. aureus and S. epidermidis were the predominant bacteria responsible for catheter-related infections in HD patients.

RETRACTION: Effect of two different techniques of arteriovenous fistula puncture on wound infection in haemodialysis patients.

Retraction: Y. Yao, H. Mao, Z. Du, and J. Liu, "Effect of Two Different Techniques of Arteriovenous Fistula Puncture on Wound Infection in Haemodialysis Patients," International Wound Journal 21, no. 3 (2024): e14659, https://doi.org/10.1111/iwj.14659. The above article, published online on 26 February 2024, in Wiley Online Library (http://onlinelibrary.wiley.com/), has been retracted by agreement between the journal Editor in Chief, Professor Keith Harding; and John Wiley & Sons, Ltd. It came to the publisher's attention from a third party that a number of articles shared concerning similarities in format and structure. Following an investigation by the publisher, the retraction has been agreed on as the peer review and publishing process for this article were found to be manipulated. The authors did not respond to the notice of retraction.

Burden of HCV among Prevalent Haemodialysis Patients in Kafr Elsheikh after National Egyptian HCV Eradication Program

Abstract Background Hepatitis C Hepatitis C virus (HCV) infection is one of the most commonly reported viral infections in both developing and developed countries, causing significant mortality and morbidity and costing billions of dollars annually. The prevalence of HCV infection in hemodialysis patients varies substantially among different geographical regions. Recent studies have shown that the HCV prevalence in hemodialysis patients varies from 1.4%–28.3% in developed countries and 4.7%–41.9% in developing countries Aim of the Work to estimate the prevalence of HCV infection and to determine the seroconversion rate in prevelant hemodilaysis in Kafr Elsheikh governorate after the hepatitis C virus infection National eradication program in Egypt and to identify the demographics leading to then non-compliance to hepatitis C virus medications and missed follow up among the prevalent hemodialysis patients with HCV infection in Kafr EL sheikh governorate, Egypt. Patients and Methods All patients were assessed for eligibility criteria and were included in the study only when they had met the following inclusion criteria: age older than 18 years old, maintained on regular hemodialysis session for more than 3 months. On the other hand, the exclusion criteria encompassed patients with acute kidney injury or any conditions necessitating temporary dialysis or patient age is less than 18 years old. 1162 prevalent hemodialysis patients in kafr el sheikh governorate, Egypt have been enrolled at our cross sectional study (multi-centric study) applying the proposed standards of the inclusion and exclusion criteria of our study design. Results Among these 1162 patients, 403 patients (34.68%) had history of positive PCR for HCV infection prior and during the national eradication campaign. Among those patients, 212 patients (52.61%) received HCV infection treatment in the form of oral and parenteral medications, while 191 patients (47.39%) didn't receive treatment. Among the patients who didn't receive the prescribed medications for HCV virus, 107 patients (56.02%) had concerns about drug complications, 22 patients didn't receive the prescribed medication due to lack of counselling while 20 patients (10.47%) did not receive treatment due to other causes as being mentally retarded, or having advanced medical comorbidities as advanced liver disease or decompensated heart failure while 42 patients (21.99%) refused to receive treatment without giving reasons. Conclusion The prevalence of HCV infection among the studied prevalent hemodialysis patients in Kafr El-Sheikh governorate is 19.4% after the HCV national eradication protocol and can be considered a major health problem. A significant percentage of the prevalent hemodialysis patients with hepatitis C virus infection refused to apply to the prescribed antiviral medications or being non complaint on medication that was mostly due to fear of developed major side effects of the prescribed medications and lack of counselling.

Prevalence of ANA and Anti-GBM Antibodies among Patients with Renal Failure in Tikrit City

Background: End-stage renal disease (ESRD) people need regular hemodialysis because they have chronic renal disease, which is a major health issue. Aim: This study aimed to evaluate the prevalence and characteristics of ANA and Anti-GBM antibodies, associated infections, and bacterial isolates in hemodialysis patients, comparing the findings with a healthy control group. Materials and Methods: A cross-sectional hospital-based study was conducted from December 1, 2023, to May 31, 2024, at Tikrit Teaching Hospital. The study comprised a cohort of 240 patients, aged 15-75 years, who were diagnosed with chronic renal disease and were receiving hemodialysis. Additionally, a control group of 40 healthy persons was included. Enzyme-linked immunosorbent assay (ELISA) technology was utilized to collect blood samples for the purpose of detecting ANA and Anti-GBM antibodies. Results: There was a modest preponderance of men in the sex distribution of hemodialysis patients. The age distribution was adequately represented throughout several decades. The investigation revealed notable disparities in the occurrence of ANA and Anti-GBM antibodies between hemodialysis patients and the control group. Out of the patients undergoing hemodialysis, 32.29% were found to have ANA antibodies, and 29.17% were found to have Anti-GBM antibodies. In contrast, none of the individuals in the control group tested positive for either type of antibody. The prevalence of Hepatitis C and B viruses among hemodialysis patients was 8.33% and 5.21% respectively. 52.08% of the patients had diabetes, whereas 57.29% had hypertension. In addition, the bacteria obtained from the mouth exhibited a varied microbial composition, with the most common species being Staphylococcus epidermidis and Streptococcus viridans. Conclusion: This study emphasizes the notable occurrence of ANA and Anti-GBM antibodies in hemodialysis patients, which is associated with a heightened susceptibility to urinary tract infections (UTIs). Implementing efficient infection control techniques and enhancing oral hygiene practices are crucial for effectively controlling infections in hemodialysis patients. Additional investigation is required to examine the intricacies of the microbial composition in this particular group and to formulate thorough measures for preventing infections.

Monitoring the Seroprevalence of Herpes Simplex Virus-1 Among Egyptian Hemodialysis Patients

Background: Hemodialysis patients are at high risk for infections due to their compromised immune systems. Herpes Simplex Virus (HSV) infections can lead to severe complications in this population. Despite its clinical significance, comprehensive data on the seroprevalence of HSV among hemodialysis patients are limited. Objective: This study aims to evaluate the seroprevalence of HSV-1 among Egyptian hemodialysis patients. Methods: A cross-sectional study was conducted with 218 participants (116 females and 102 males). Among these, 132 (60.6%) were undergoing hemodialysis, while 86 (39.4%) had normal kidney function and were free from HCV, CMV, and HIV infections. Serum samples were analyzed for IgG antibodies against HSV-1. Statistical analyses were performed to determine HSV seroprevalence. Results: The study observed a significantly higher prevalence of HSV-1-IgG antibodies in hemodialysis patients (84.1%) compared to the control group (66.3%, P<0.01). Additionally, HSV-1-IgM positivity was also higher in the hemodialysis group (41.6%) compared to the control group (32.6%, P<0.05). These findings highlight the need for vigilant monitoring and preventive strategies for HSV infections in hemodialysis patients.

The Prevalence and Associated Factors of Hepatitis B and C Virus in Hemodialysis Patients in Ibb Governorate, Yemen.

Introduction Hepatitis C virus (HCV) and hepatitis B virus (HBV) among patients receiving hemodialysis (HD) remain a major public health problem. However, information is limited about these infections among HD patients in Yemen. This study aimed to estimate the prevalence and associated risk factors of HBV and HCV infections among HD patients in the Ibb governorate, Yemen, and to identify the risk factors for infections in such patients. Methods A cross-sectional study of 374 patients with renal failure who regularly underwent HD at the Al-Thawra Hospital in Ibb city, Yemen, was performed after they agreed to participate and signed informed consent. Enzyme-linked immunoassay (ELISA) was used to test the serum levels of anti-HCV antibodies and hepatitis B surface antigen (HBsAg). Patient data (demographic characteristics and risk factors) were collected via an interview questionnaire and medical records. Logistic regression analysis and chi-square tests were used to analyze the results. Results The overall prevalence of HCV was 31% (n=116), whereas that of HBV was 6.15% (n=23). Three (0.8%) patients had both HCV and HBV. The logistic regression analysis revealed a significant association between an increased number of units of blood transfused (OR = 3.1; 95% CI: 1.7-5.6; p< 0.001), a long duration of dialysis (OR = 3.2; 95% CI: 1.9-5.2; p = 0.001), and HCV infection in HD patients. On the other hand, a history of cupping therapy (Hijama) was significantly associated (OR = 3.4; 95% CI: 1.3-8.77; p < 0.011) with HBV infection in HD patients. Conclusion HCV and HBV infections are more common among HD patients in Yemen than in most Middle Eastern countries. However, the current prevalence rates are declining compared with previously published data among Yemeni HD patients. The duration of HD and number of blood units were independent risk factors for HCV infection, and patients with a history of cupping were identified as having an increased risk of HBV infection. These findings underscore the need to implement strict infection control in HD units.

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

Background Patients undergoing hemodialysis for End-Stage Renal Disease (ESRD) are at risk for Hemodialysis Catheter-Related Bloodstream Infections (CRBSIs). This study evaluates the incidence, risk factors, organism types, and outcomes of CRBSI in adult patients on maintenance hemodialysis at King Faisal Hospital, Rwanda. Methods This was a prospective cohort study of adult patients with end-stage renal disease undergoing hemodialysis via central venous hemodialysis catheters at King Faisal Hospital, Rwanda. Upon receiving the IRB approval, 81 eligible patients, women, and men aged between 19 and 74, were enrolled. Restricted Mean Survival Time (RMST) analysis evaluated the risk factors for CRBSI. The statistical significance was determined using p-values, with a cut-off of 0.05. Results The incidence of CRBSI was found to be 0.78 episodes per 1,000 catheter-days. Acute hemodialysis catheter type and anemia were associated with increased risk for CRBSI, with a P-value less than 0.05. In addition, all CRBSI cases were due to bacteria, with 52.63% gram-negative and 47.37% gram-positive. Out of 19 CRBSI events,nine cases (47.37%) required hospitalization with a median duration of seven days. Approximately half of the CRBSIs required catheter removal. No metastatic infection or death was noted. Conclusion The present study demonstrated that our hemodialysis unit has an incidence of 0.78 episodes per 1,000 catheter-days. Catheter type and anemia were significantly associated with CRBSI.

Seroprevalence of HCV infection among Indian patients with hemodialysis.

Hepatitis C virus (HCV) exists as the most common hepatotropic disease with a severe complication in significant patients. Maximum incidence of HCV infection occurred specifically in hemodialysis patients and they were related with increased illness and fatality rate. Therefore, it is of interest to know the seroprevalence of HCV infections in hemodialysis patients using anti-HCV and PCR diagnosis. Hence, this study was carried out at a tertiary care hospital for a period of 12 months. 92 blood samples were collected and subjected for the detection of HCV antibodies using ELISA followed by RT-PCR. Out of 92 HD patient samples, 7 were positive for Anti-HCV and 9 samples showed positive for HCV RNA. Thus, ELISA has less sensitivity with false negative rate for identification of HCV infection. Thus, hemodialysis patients should be routinely screened for HCV using RT-PCR for adequate management of the disease.

Prevalence and risk factors of latent tuberculosis infection in hemodialysis patients in southwest Iran.

Tuberculosis (TB) is a significant global health concern, particularly in developing countries. Diagnosing latent tuberculosis infection (LTBI) in hemodialysis patients is crucial because of the risk of developing active tuberculosis in this population due to attenuated immune response. Herein, we assessed the prevalence of LTBI in hemodialysis patients. In this cross-sectional study, we included all patients referred to hemodialysis centers in Kohgiluyeh and Boyer-Ahmad Province, southwest Iran, in 2018 through census sampling. Tuberculin skin test (TST) was utilized to screen the patients for LTBI. All steps were done by trained physicians. In total, 183 patients (mean age: 59.3, SD= 16.0) were included in the study of which 76 (41.5%) were females, and 107 (58.5%) were males. Neither the patients nor their family members had a history of tuberculosis. Assuming an above 5-millimeter enduration as a positive TST result, 22 patients (12%) had LTBI. None of the demographic or clinical features differed between TST -negative and -positive groups. Hemodialysis patients are prone to LTBI due to several immunological and environmental factors. Screening for LTBI may be beneficial to prevent active tuberculosis in this population.

#831 Associations of quality of life with hospitalization for infection and subsequent death in hemodialysis patients: Osaka Dialysis Complication Study

Abstract Background and Aims Health-related quality of life (HRQOL) as self-reported health status is known to predict mortality in hemodialysis (HD) patients. Infection is one of the major causes for death in those patients, although limited studies have examined possible associations of HRQOL with infection-related outcomes. In the present study, we examined the associations of HRQOL scores with all-cause mortality, hospitalization for infection, and subsequent death in HD patients. Method Patients for this study were selected from the Osaka Dialysis Complication Study (ODCS) which is a prospective cohort study from 2012 to 2017 including a total of 1696 HD patients. HRQOL was assessed by Medical Outcomes Study short form 36 (SF-36) questionnaire to determine scores of the physical component summary (PCS) and the mental component summary (MCS) at baseline, and patients were divided into tertiles of them. The key outcomes were all-cause mortality, hospitalization for infection, and subsequent death after infection. Association was analyzed with Cox proportional hazards models or Fine-Gray models to estimate hazard ratios (HRs) with the highest tertile of PCS or MCS (T3) as referent. Models were unadjusted and adjusted for potential confounders including major demographic factors, traditional cardiovascular risk factors, and the factors related to chronic kidney disease-mineral and bone disorder (CKD-MBD), protein energy wasting and inflammation, and renal anemia. Results We analyzed data from 1464 patients, and we identified 384 all-cause deaths, 321 hospitalizations for infections, and 143 subsequent deaths following infection. Risk of all-cause death was the highest in the lowest PCS tertile in unadjusted model, and this association remained significant in multivariable-adjusted models. In addition, a lower PCS was significantly predictive of a higher risk of both hospitalization for infection in models unadjusted and adjusted for demographic variables, but not significant in a model adjusted for all confounders. However, risk of death after hospitalization for infection was significantly higher in the lowest PCS tertile in unadjusted and in multivariable-adjusted models, compared with the highest PCS tertile. In contrast, MCS was not associated with all-cause mortality, hospitalization for infection, or death following hospitalization for infection. Conclusion A low PCS was associated with both hospitalization for infection and subsequent death after infection in HD patients, but it was more closely associated with the latter. This study revealed that HRQOL, particularly its physical component, is an independent predictor of infection-related outcomes in this population.

Prevalence and risk factors of latent tuberculosis infection in hemodialysis patients in southwest Iran

INTRODUCTION. Tuberculosis (TB) is a significant global health concern, particularly in developing countries. Diagnosing latent tuberculosis infection (LTBI) in hemodialysis patients is crucial because of the risk of developing active tuberculosis in this population due to attenuated immune response. Herein, we assessed the prevalence of LTBI in hemodialysis patients. METHODS. In this cross-sectional study, we included all patients referred to hemodialysis centers in Kohgiluyeh and Boyer-Ahmad Province, southwest Iran, in 2018 through census sampling. Tuberculin skin test (TST) was utilized to screen the patients for LTBI. All steps were done by trained physicians. RESULTS. In total, 183 patients (mean age: 59.3, SD= 16.0) were included in the study of which 76 (41.5%) were females, and 107 (58.5%) were males. Neither the patients nor their family members had a history of tuberculosis. Assuming an above 5-millimeter enduration as a positive TST result, 22 patients (12%) had LTBI. None of the demographic or clinical features differed between TST -negative and -positive groups. CONCLUSION. Hemodialysis patients are prone to LTBI due to several immunological and environmental factors. Screening for LTBI may be beneficial to prevent active tuberculosis in this population.

Exploration of agr types, virulence-associated genes, and biofilm formation ability in Staphylococcus aureus isolates from hemodialysis patients with vascular access infections.

Staphylococcus aureus, is a pathogen commonly encountered in both community and hospital settings. Patients receiving hemodialysis treatment face an elevated risk of vascular access infections (VAIs) particularly Staphylococcus aureus, infection. This heightened risk is attributed to the characteristics of Staphylococcus aureus, , enabling it to adhere to suitable surfaces and form biofilms, thereby rendering it resistant to external interventions and complicating treatment efforts. Therefore this study utilized PCR and microtiter dish biofilm formation assay to determine the difference in the virulence genes and biofilm formation among in our study collected of 103 Staphylococcus aureus, isolates from hemodialysis patients utilizing arteriovenous grafts (AVGs), tunneled cuffed catheters (TCCs), and arteriovenous fistulas (AVFs) during November 2013 to December 2021. Our findings revealed that both MRSA and MSSA isolates exhibited strong biofilm production capabilities. Additionally, we confirmed the presence of agr types and virulence genes through PCR analysis. The majority of the collected isolates were identified as agr type I. However, agr type II isolates displayed a higher average number of virulence genes, with MRSA isolates exhibiting a variety of virulence genes. Notably, combinations of biofilm-associated genes, such as eno-clfA-clfB-fib-icaA-icaD and eno-clfA-clfB-fib-fnbB-icaA-icaD, were prevalent among Staphylococcus aureus, isolates obtained from vascular access infections. These insights contribute to a better understanding of the molecular characteristics associated with Staphylococcus aureus, infections in hemodialysis patients and provided more targeted and effective treatment approaches.

Risk factors for catheter-associated bloodstream infection in hemodialysis patients: A meta-analysis.

This meta-analysis aimed to elucidate the risk factors contributing to catheter-associated bloodstream infection in hemodialysis patients. Comprehensive literature searches were conducted in both English and Chinese databases, which encompassed PubMed, Cochrane Library, Embase, CNKI, Wanfang Data, VIP Database and China Biomedical Literature Database. The search timeframe extended from each database's inception to March 8, 2023. Two independent researchers executed literature screening, data extraction, and quality assessment using the Newcastle-Ottawa Scale. Statistical analysis of the data was performed using RevMan 5.3 software, facilitating the identification of significant risk factors associated with catheter-related bloodstream infections in hemodialysis patients. This meta-analysis is registered with PROSPERO under the registration number CRD42023406223. Forty-nine studies were incorporated into this meta-analysis, from which 22 risk factors were examined. Through the analysis, 17 risk factors exhibited statistical significance (P < 0.05): age (OR = 1.52, 95% CI [0.49, 4.68]), diabetes (OR = 2.52, 95% CI [1.95, 3.25]), kidney disease (OR = 3.45, 95% CI [1.71, 6.96]), history of catheter-associated infection (OR = 2.79, 95% CI [1.96, 3.98]), hypertension (OR = 1.43, 95% CI [1.08, 1.91]), dialysis duration (OR = 3.06, 95% CI [1.70, 5.50]), catheter placement site (OR = 1.91, 95%CI [1.35, 2.70]), catheter duration (OR = 2.06, 95% CI [1.17, 3.60]), number of catheterizations (OR = 4.22, 95% CI [3.32, 5.37]), catheter types (OR = 3.83, 95% CI [2.13, 6.87]), CD4+ cells (OR = 0.33, 95% CI [0.18, 0.63]), albumin (ALB, OR = 2.12, 95% CI [1.15, 3.91]), C-reactive protein (CRP, OR = 1.73, 95% CI [1.47, 2.03]), hemoglobin (Hb, OR = 1.48, 95% CI [0.54, 4.07]), procalcitonin (PCT, OR = 1.05, 95% CI [1.03, 1.06]), inadequate hand hygiene (OR = 5.32, 95% CI [1.07, 26.37]), and APACHE II scores (OR = 2.41, 95% CI [1.33, 4.37]). This meta-analysis suggests that age, diabetes, kidney disease, history of catheter-associated infection, hypertension, dialysis duration, catheter placement site, catheter duration, number of catheterizations, catheter type, CD4+ cells, albumin, C-reactive protein, hemoglobin, procalcitonin, inadequate hand hygiene, and APACHE II scores significantly influence the incidence of catheter-associated bloodstream infection in hemodialysis patients.

Effect of two different techniques of arteriovenous fistula puncture on wound infection in haemodialysis patients.

Safe and effective arteriovenous fistula (AVF) puncture is very important to reduce the wound complications of haemodialysis (HD). For AVF puncture in dialysis patients, there is a lack of clarity and consistency regarding the relative advantage of buttonhole (BH) over rope-ladder (RL) cannulae in terms of wound complications. The study was published in several scientific databases including Cochrane Library, PubMed and Embase by October 2023. Data from all controlled trials looking at the effect of BH and RL on wound complications in haemodialysis patients were included. The articles were written in English, and they were about adult who had AVF while on dialysis. Studies with or without BH or RL treatment were excluded from the analysis. The data was analysed with RevMan5.3 software. Out of 215 trials, 9 were chosen for the final analysis. The study publication dates were between 2000 and 2023. Of these, 17 326 patients received AVF therapy. Among them, there were 3070 BH and 14 256 RL. In 9 studies, RL had a lower risk of postoperative wound infection compared to BH (OR, 3.38; 95% CI, 3.06, 3.73 p < 0.0001); In all 3 studies, there were no statistically significant differences in the risk of post operative bleeding in RL versus BH(OR, 0.76; 95% CI, 0.25, 2.33 p = 0.63). Our studies have demonstrated that RL trocars are superior to BH trocars in the prevention of wound infection.

Prevention of Catheter-Associated Bloodstream Infections in Hemodialysis Patients

This study aimed to assess the efficacy of preventive measures against catheter-associated bloodstream infections in hemodialysis patients. Seventy patients undergoing hemodialysis treatment at our hospital from January 2020 to January 2023 were recruited and randomly assigned in a 1:1 ratio to receive either conventional nursing (control group) or targeted preventive nursing (observation group), with 35 cases in each group. Outcome measures for nursing effects assessment included nursing outcomes, the incidence of catheter-related bloodstream infections, patient stress, and quality of life. Targeted preventive nursing demonstrated a significantly lower incidence of catheter-related bloodstream infection and adverse catheter events compared to conventional care (P &lt;0.05). Moreover, targeted preventive nursing significantly reduced catheter retention duration in comparison to conventional care (P &lt;0.05). The higher quality of nursing associated with targeted preventive nursing was evident in the elevated nursing quality scores (P &lt;0.05). Patients who underwent targeted preventive nursing exhibited milder stress compared to those receiving routine care, as indicated by lower hemodialysis stress scale (HSS) scores (P &lt;0.05). Furthermore, the observation group, receiving targeted preventive nursing, reported higherWorld Health Organization quality of life (WHOQOL-BREF) scores than the control group, suggesting an improved quality of life (P &lt;0.05). Targeted preventive care for catheter-associated bloodstream infections in hemodialysis patients not only fortifies the rigor and standard of care but also effectively reduces the infection rate, shortens catheter retention time, alleviates patient stress, and enhances their overall quality of care and survival.

“Index Case of Multiresistant Ochrobactrum Anthropi in an Immunocompetent Postpartum Female with Posterior Reversible Encephalopathy Syndrome: A Unique Case at a Tertiary Care Centre in India”

Ochrobactrum anthropi, an emerging nosocomial pathogen associated with medical devices, presents a distinct challenge in healthcare. While prevalent in patients with invasive devices, such as central venous catheters, its occurrence in hemodialysis (HD) patients is rarely reported. This study details a case of O. anthropi bacteremia-induced septic shock in an immunocompetent, non-diabetic, post-LSCS-postpartum female undergoing intermittent dialysis at AIIMS Rishikesh, a tertiary care center in Uttarakhand, India. In addition to the clinical case, we provide a concise review of O. anthropi infections in HD patients, emphasizing the need for rapid pathogen identification, susceptibility testing, and tailored antimicrobial therapy for favorable outcomes.

Two versus three doses of COVID-19 vaccine and post-vaccination COVID-19 infection in hemodialysis patients

Background and aimPatients with chronic kidney disease including those undergoing hemodialysis (HD) constitute a particularly challenging group regarding COVID-19 vaccination. The present study aimed to compare the rate of reinfection after two and three doses of Sinopharm COVID-19 vaccine in HD patients. Patients and methodsThe study included 80 HD patients who received three doses of Sinopharm COVID-19 vaccine. In addition, there were another 80 patients who received only two doses of the vaccine. Patients in the latter group were selected based on propensity matching score with 1:1 ratio. Patients were monitored for post-vaccination COVID-19 infection using PCR examination of nasopharyngeal swabs. Patients were also monitored for post-vaccination complications including general complaints (headache, fever, fatigue), injection site complaints (arm pain, swelling, itching, rash), musculoskeletal complaints (muscle spasm or pain, joint pain) and others. All patients were followed for six months. ResultsThe present study included 80 patients submitted to COVID-19 vaccination with two doses of Sinopharm vaccine (GI) and other 80 patients who received three doses of the same vaccine (GII). At the end of follow up, 11 patients (13.8 %) in GI caught COVID-19 infection. In contrast, no patient in GII had infection (p<0.001). Comparison between patients who had COVID-19 infection and those without infection revealed that the former subgroup had significantly lower BMI (23.3 ± 2.3 versus 27.5 ± 8.1 Kg/m2), higher frequency of associated Hepatitis C (HCV) infection (54.6 % versus 2.9 %, p<0.001) and higher serum ferritin levels [median (IQR): 1101.0 (836.0-1564.0) versus 675.0 (467.0-767.7) ng/mL, p=0.01]. Binary logistic regression analysis identified high serum ferritin levels [OR (95% CI): 0.014 (0.001-0.15), p<0.001] and associated HCV infection [OR (95% CI): 0.99 (0.98-1.01), p=0.02] as significant predictors of post-vaccination COVID-19 infection in multivariate analysis. ConclusionsA three dose regime of Sinopharm COVID-19 vaccine associated with significantly lower rate of reinfection COVID-19 infection in HD patients. Infected patients had significantly lower BMI, higher frequency of HCV and higher ferritin levels.