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Hemodialysis catheter-related infections: Results of a tertiary care center study in Saudi Arabia

Ibrahim Masoodi, Fahad Rajallah Alharth, Summaiya Irshad, Abdul Rehman Mastan, Ahmed Alzaidi, Khalid A Balbaid, Naif Alomairi, Irshad Sirwal.

Abstract
Background: Catheter-related bloodstream infection (CRBSI) is frequent causes of mortality and morbidity in dialysis patients, and the sensitivity pattern of antimicrobials varies across different dialysis centers.

Objectives: The present study aimed to investigate the pattern of microbes grown from catheter sites, blood and the sensitivity pattern. The data could
help in initiating an empiric antimicrobial therapy.

Materials and Methods: This was an observational retrospective study at Regional Kidney Center at King Abdul Aziz Specialist Hospital, Taif, in the western region of Saudi Arabia. The data collected were related to patients’ demographics, etiology of renal failure, presence of comorbidities, site of catheter insertion, and duration. Furthermore, microbiological data including cultures from catheter sites, blood, and catheters’ tips and antibiotic sensitivity.

Results: Data on 130 patients (66 females, 50.8%) undergoing hemodialysis from June 2017 to March 2018 were analyzed. The infection rate was 23.6% in this study. In all patients with CRBSI, the catheters were removed, and antibiotics given. The highest infection rates (38.4%) were noted with femoral vein inserted catheters. However, the clinical sepsis was more with jugular catheters. Staphylococcus aureus was prevalent organism, and cephalosporins had the highest sensitivity. Ten catheters found to be mal functional were replaced.

Conclusion: Chronic kidney disease patients with diabetes and ischemic heart disease were more prone to CRBSI. Femoral catheters had significantly higher infection rates. S. aureus was the most common type of isolated bacterial strain and cephalosporins showed the highest sensitivity for the isolated bacteria.

Key words: Hemodialysis; Hemodialysis Access; Vascular Access Catheter-related Bloodstream Infection


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