Incidence, microbiological aspects and associated risk factors of catheter-related bloodstream infections in adults on chronic haemodialysis at a tertiary hospital in Uganda

Nanyunja, Doreen; Chothia, Mogamat-Yazied; Opio, Kenneth; Ocama, Ponsiano; Bwanga, Freddie; Kiggundu, Daniel Ssekikubo; Byakika-Kibwika, Pauline

doi:10.1016/j.ijregi.2022.09.002

Cited by 12 publications

(12 citation statements)

References 46 publications

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“…Escherichia coli bloodstream infections were observed throughout the study period. These ndings were similar to other studies (44,45). Therefore E.coli blood stream infections are common in Uganda and these infections are usually associated with onset UTIs (46).…”

Section: Discussionsupporting

confidence: 93%

Surveillance of Antimicrobial resistance among organism causing Bacteremia in patients admitted in Mbarara Regional Referral Hospital, Mbarara, Southwestern Uganda

bazira,

Petra,

Iramiot

et al. 2024

Preprint

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Blood stream infections are the major cause of fevers of undetermined origin in Africa. The continuing emergence of pathogenic microorganisms that are resistant to first-line antimicrobials is a cause of increasing Anti-Microbial Resistance concern. This study aimed at understanding the surveillance of antimicrobial resistance in order to serve as a quality assurance tool to determine common pathogens causing bacteremia, trends of antimicrobial resistance which will guide drug-policy decisions and facilitate rational use of drugs to prevent the further emergence of antimicrobial resistance. This study analyzed results of blood cultures that were routinely taken from patients of different age groups with fever or suspicion of sepsis among patients admitted in different wards of Mbarara Regional Referral Hospital and transported to Mbarara University of Science and Technology, the microbiology laboratory between 2015 and 2022. Bacterial isolates of clinical significance from specimens received during the study period were recorded in WHONET (surveillance software) and exported to STATA for analysis. Bloodstream infections were confirmed in 259 cases over the seven-year study period. Gram positive pathogens accounted for 160 (61.7%) in the confirmed infections while gram negative pathogens accounted for 99 (38.2%) of the cases. Staphylococcus aureus was the most isolated pathogen accounting for 57.1% (n=148) of the blood stream infections. Both the Gram positive and gram negative bacteria demonstrated increasing resistance towards among Ceftriaxone and Ampicillin. Using advanced information technology to study antimicrobial susceptibility patterns of resistant bacteria in blood culture isolates will be useful in directing empiric antibiotic therapy of severe sepsis in Uganda because laboratory data being will be collected and analyzed rapidly.

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Section: Discussionsupporting

confidence: 93%

Surveillance of Antimicrobial resistance among organism causing Bacteremia in patients admitted in Mbarara Regional Referral Hospital, Mbarara, Southwestern Uganda

bazira,

Petra,

Iramiot

et al. 2024

Preprint

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“…11 This risk factor has also been observed in other studies with smaller sample sizes and in a mostly adult population. 13,16 Such association may be explained by the development of biofilms in CVCs, which prevent the elimination of pathogenic bacteria through the use of antibiotics. 13,14,23 In our hospital, administering systemic antibiotic therapy without routinely removing the catheter in case of confirmed infection is a common practice due to the difficulties involved in the insertion of new catheters in pediatric patients.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 According to the different series, the incidence of bacteriemia a s s o c i a t e d w i t h n o n -t u n n e l e d C V C s i s 3.25-10.8 events per 1000 catheter-days, while that of tunneled CVCs is 0.55-5.5. [8][9][10][11][12][13][14] The most common microorganisms are Staphylococcus aureus or epidermidis. [8][9][10][11][12][13][14] Among adults, the risk factors for infection include a prolonged CVC dwell time, decrease in hemoglobin and albumin serum levels, prior catheter-related bacteremia, diabetes, iron overload, nasal colonization with Staphylococcus aureus, malnutrition, and advanced age.…”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10][11][12][13][14] The most common microorganisms are Staphylococcus aureus or epidermidis. [8][9][10][11][12][13][14] Among adults, the risk factors for infection include a prolonged CVC dwell time, decrease in hemoglobin and albumin serum levels, prior catheter-related bacteremia, diabetes, iron overload, nasal colonization with Staphylococcus aureus, malnutrition, and advanced age. 8,11,13,15,16 Until 2019, in our department, hemodialysis was the initial dialysis modality in 82% of children with ESRD and was the continued therapy in 45%.…”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10][11][12][13][14] Among adults, the risk factors for infection include a prolonged CVC dwell time, decrease in hemoglobin and albumin serum levels, prior catheter-related bacteremia, diabetes, iron overload, nasal colonization with Staphylococcus aureus, malnutrition, and advanced age. 8,11,13,15,16 Until 2019, in our department, hemodialysis was the initial dialysis modality in 82% of children with ESRD and was the continued therapy in 45%. 17 A temporary CVC was the initial access in 80% of patients because tunneled catheter insertion was not a routine practice.…”

Section: Introductionmentioning

confidence: 99%

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Bacteremia associated with non-tunneled central venous catheters in children undergoing chronic hemodialysis

2024

Arch Argent Pediat

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Introduction. Central venous catheter (CVC)-related infection is the main complication observed in patients undergoing hemodialysis with this type of venous access.Objective. To estimate the incidence of non-tunneled CVC-related bacteremia, analyze the frequency of causative agents, and explore associated risk factors in children undergoing hemodialysis. Population and methods.Retrospective study in children receiving hemodialysis via a non-tunneled CVC between June 1 st , 2015 and June 30 th , 2019. A logistic regression was carried out to assess risk factors that were predictors of CVC-related bacteremia. Independent risk factors were described as odds ratios with their corresponding 95% confidence interval (CI). A value of p < 0.05 was considered statistically significant. Results.A total of 121 non-tunneled CVCs were included in this study. The incidence of bacteremia was 3.15 per 1000 catheter-days. The most commonly isolated microorganism was Staphylococcus epidermidis (16 cases, 51.5%). Prior catheter infection was the only independent risk factor for the development of bacteremia associated with non-tunneled CVC (OR: 2.84, 95% CI: 1.01-7.96, p = 0.04).Conclusions. Prolonged use of non-tunneled CVCs for chronic hemodialysis was associated with a low incidence of bacteremia. Gram-positive microorganisms prevailed among causative agents. A prior CVC infection almost trebled the risk for CVC-related bacteremia in our pediatric population receiving hemodialysis.

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Microbial organisms and antibiotic sensitivity patterns in patients with catheter-related bloodstream infections at a tertiary hospital

Puplampu,

Opoku-Asare,

Ganu

et al. 2024

Clinical Infection in Practice

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Incidence, microbiological aspects and associated risk factors of catheter-related bloodstream infections in adults on chronic haemodialysis at a tertiary hospital in Uganda

Cited by 12 publications

References 46 publications

Surveillance of Antimicrobial resistance among organism causing Bacteremia in patients admitted in Mbarara Regional Referral Hospital, Mbarara, Southwestern Uganda

Surveillance of Antimicrobial resistance among organism causing Bacteremia in patients admitted in Mbarara Regional Referral Hospital, Mbarara, Southwestern Uganda

Bacteremia associated with non-tunneled central venous catheters in children undergoing chronic hemodialysis

Microbial organisms and antibiotic sensitivity patterns in patients with catheter-related bloodstream infections at a tertiary hospital

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