Frequency of Catheter Infections in Patients of Hemodialysis Despite Using Antibiotic Lock

Catheter Infections Despite Using Antibiotic Lock

Authors

  • Sidra Rashid Department of Nephrology, Liaquat National Hospital, Karachi, Pakistan
  • Maria Quershi Department of Nephrology, Karachi Institute of Kidney Diseases, Karachi, Pakistan
  • Farya Moon Department of Nephrology, Karachi Institute of Kidney Diseases, Karachi, Pakistan
  • Mehwish Qamar epartment of Nephrology, SHED Hospital, Karachi, Pakistan
  • Khurram Danial Department of Nephrology, Karachi Institute of Kidney Diseases, Karachi, Pakistan
  • khadijah Abid Department of Public Health, Shaheed Zulfikar Ali Bhutto Institute of Science and Technology, Karachi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v3i07.394

Keywords:

Catheter, Infection, Hemodialysis, Antibiotic Locks

Abstract

Non-tunneled catheters are associated with many complications, including infections and thrombosis. Objective: To determine the frequency of catheter infections in patients of hemodialysis despite using antibiotic locks, in a Tertiary Care Hospital Karachi. Methods: It was a cross-sectional study conducted at the department of nephrology, Liaquat national hospital and medical college, Karachi, Pakistan from 18th October 2020 to 18th April 2021. Patients of age 20 to 70 years of either gender on hemodialysis through double lumen catheter– non-cuffed for > 2 weeks were included in the study. Brief history was taken from all the patients. Gentamicin lock solutions were administered in all patients. Catheter tip was sent to institutional laboratory for culture and sensitivity to reach the outcome i-e catheter related infection. Results: The mean age was 58.97 + 14.82 years. The catheter related blood stream infection was in 21 patients (17.5%). The most common organism was coagulase negative Staphylococci (CoNS) (5.9%), followed by Vancomycin-resistant Enterococcus (VRE) (4.2%), respectively. There was insignificant association observed between catheter related blood stream infection and age groups, gender, comorbids, duration of catheter insertion and hemodialysis, site of catheter infection and reasons of hemodialysis (p > 0.05). Conclusions: Catheter-related infections in patients of hemodialysis despite using antibiotic locks is frequent but it has been observed that gram negative infections have responded well to gentamicin lock solution, where as in our study most common organism responsible for infection is coagulase negative Staph. followed by VRE

References

Carney EF. The impact of chronic kidney disease on global health. Nature Reviews Nephrology. 2020 May; 16(5): 251-. doi: 10.1038/s41581-020-0268-7

Mills KT, Xu Y, Zhang W, Bundy JD, Chen CS, Kelly TN, et al. A systematic analysis of worldwide population-based data on the global burden of chronic kidney disease in 2010. Kidney International. 2015 Nov; 88(5): 950-7. doi: 10.1038/ki.2015.230

Luyckx VA, Tonelli M, Stanifer JW. The global burden of kidney disease and the sustainable development goals. Bulletin of the World Health Organization. 2018 Jun; 96(6): 414-422. doi: 10.2471/BLT.17.206441

Bindroo S and Rodriguez Q. BS; Challa, HJ Renal Failure. StatPearls; StatPearls Publishing: Treasure Island, FL, USA. 2022. Available at: https://www.ncbi.nlm.nih.gov/books/NBK519012/.

Roca-Tey R. Permanent arteriovenous fistula or catheter dialysis for heart failure patients. The Journal of Vascular Access. 2016 Mar; 17(1_suppl): S23-9. doi: 10.5301/jva.5000511

Santoro D, Benedetto F, Mondello P, Pipitò N, Barillà D, Spinelli F, et al. Vascular access for hemodialysis: current perspectives. International Journal of Nephrology and Renovascular Disease. 2014 Jul; 7: 281-294. doi: 10.2147/IJNRD.S46643

Kusumoto T, Mitsushio K, Kajiwara N. A double‐lumen catheter for hemodialysis dislocated into the mediastinum. Clinical Case Reports. 2019 Sep; 7(9): 1817-8. doi: 10.1002/ccr3.2326

Flick AI and Winters R. Vascular Tunneled Central Catheter Access. 2020. Available at: https://www.ncbi.nlm.nih.gov/books/NBK557614/.

Miller LM, MacRae JM, Kiaii M, Clark E, Dipchand C, Kappel J, et al. Hemodialysis tunneled catheter noninfectious complications. Canadian Journal of Kidney Health and Disease. 2016 Sep; 3: 2054358116669130. doi: 10.1177/2054358116669130

Al-Solaiman Y, Estrada E, Allon M. The spectrum of infections in catheter-dependent hemodialysis patients. Clinical Journal of the American Society of Nephrology. 2011 Sep; 6(9): 2247-52. doi: 10.2215/CJN.03900411

Wilcox T. Catheter-Related Bloodstream Infections. Seminars in Interventional Radiology. 2009 Jun; 26(02): 139–43. doi: 10.1055/s-0029-1222458

Shahar S, Mustafar R, Kamaruzaman L, Periyasamy P, Pau KB, Ramli R. Catheter-Related Bloodstream Infections and Catheter Colonization among Haemodialysis Patients: Prevalence, Risk Factors, and Outcomes. International Journal of Nephrology. 2021 Jun; 2021: 1-9. doi: 10.1155/2021/5562690

Menegueti MG, Betoni NC, Bellissimo-Rodrigues F, Romão EA. Central venous catheter-related infections in patients receiving short-term hemodialysis therapy: incidence, associated factors, and microbiological aspects. Revista da Sociedade Brasileira de Medicina Tropical. 2017 Nov; 50(06): 783-7. doi: 10.1590/0037-8682-0438-2017

Gómez J, Pimienta L, Pino R, Hurtado M, Villaveces M. Prevalence of catheter-related haemodialysis infections in Hospital Universitario San Rafael, Bogotá, Colombia. Revista Colombiana de Nefrología. 2018 Jun; 5(1): 17-25. doi: 10.22265/acnef.5.2.283

Johansen KL, Gilbertson DT, Wetmore JB, Peng Y, Liu J, Weinhandl ED. Catheter-Associated Bloodstream Infections among Patients on Hemodialysis: Progress before and during the COVID-19 Pandemic. Clinical Journal of the American Society of Nephrology. 2022 Mar; 17(3): 429-33. doi: 10.2215/CJN.11360821

Soi V, Moore CL, Kumbar L, Yee J. Prevention of catheter-related bloodstream infections in patients on hemodialysis: challenges and management strategies. International Journal of Nephrology and Renovascular Disease. 2016 Apr; 9: 95-103. doi: 10.2147/IJNRD.S76826

Thompson S, Wiebe N, Klarenbach S, Pelletier R, Hemmelgarn BR, Gill JS, et al. Catheter-related blood stream infections in hemodialysis patients: a prospective cohort study. BMC Nephrology. 2017 Dec; 18(1) :1-8. doi: 10.1186/s12882-017-0773-5

Shah S, Singhal T, Naik R, Thakkar P. Incidence and etiology of hemodialysis catheter related blood stream infections at a tertiary care hospital in Mumbai: a 5 year review. Indian Journal of Nephrology. 2020 Mar; 30(2): 132-3. doi: 10.4103/ijn.IJN_127_19

Zhang HH, Cortés-Penfield NW, Mandayam S, Niu J, Atmar RL, Wu E, et al. Dialysis Catheter–related bloodstream infections in patients receiving hemodialysis on an emergency-only basis: a retrospective cohort analysis. Clinical Infectious Diseases. 2019 Mar; 68(6): 1011-6. doi: doi.org/10.1093/cid/ciy555

Shehzadi U, Akhtar N, Usman MA, Chaudhry A, Noor F, Rafique N. Frequency of hemodialysis catheter related infectious complications in patients with end stage renal disease. Pakistan Armed Forces Medical Journal. 2019 Jun; 69(3): 477-82.

Gahlot R, Nigam C, Kumar V, Yadav G, Anupurba S. Catheter-related bloodstream infections. International Journal of Critical Illness and Injury Science. 2014 Apr; 4(2): 162-7. doi: 10.4103/2229-5151.134184

Pitiriga V, Kanellopoulos P, Bakalis I, Kampos E, Sagris I, Saroglou G, et al. Central venous catheter-related bloodstream infection and colonization: the impact of insertion site and distribution of multidrug-resistant pathogens. Antimicrobial Resistance and Infection Control. 2020 Dec; 9(1): 1-8. doi: 10.1186/s13756-020-00851-1

Shoaib M, Das B, Suhail MA, Memon R, Kumar K, Hinduja B, et al. Frequency of double lumen catheter related infections in hemodialysis patients. Journal of Peoples University of Medical and Health Sciences Nawabshah.(JPUMHS). 2021 Jun; 11(2): 33-6.

Mahmood SN, Asif S, Anwar MA, Naveed OK. Frequency and microbiological profile of catheter-related infections in hemodialysis patients receiving gentamicin as antimicrobial lock therapy for prophylaxis. Pakistan Journal of Kidney Diseases. 2020 Jan; 4(03): 1-6. doi: 10.53778/pjkd40350

Scheuch M, Freiin von Rheinbaben S, Kabisch A, Engeßer J, Ahrendt S, Dabers T, et al. Staphylococcus aureus colonization in hemodialysis patients: a prospective 25 months observational study. BMC Nephrology. 2019 Dec; 20(1): 1-2. doi: 10.1186/s12882-019-1332-z

Cuervo G, Camoez M, Shaw E, Dominguez MÁ, Gasch O, Padilla B, et al. Methicillin-resistant Staphylococcus aureus (MRSA) catheter-related bacteraemia in haemodialysis patients. BMC Infectious Diseases. 2015 Dec; 15(1): 1-7. doi: 10.1186/s12879-015-1227-y

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Published

2022-12-31
CITATION
DOI: 10.54393/pjhs.v3i07.394
Published: 2022-12-31

How to Cite

Rashid, S., Quershi, M., Moon, F., Qamar, M., Danial, K., & Abid, khadijah. (2022). Frequency of Catheter Infections in Patients of Hemodialysis Despite Using Antibiotic Lock: Catheter Infections Despite Using Antibiotic Lock. Pakistan Journal of Health Sciences, 3(07), 219–223. https://doi.org/10.54393/pjhs.v3i07.394

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