Reducing Catheter-Related Infections in Hemodialysis Patients

Landry, Daniel; Braden, Gregory

doi:10.2215/cjn.04700514

Cited by 16 publications

(14 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This practice has been done as per European Best Practices Report considering avoiding antibiotic resistance. 5,6 This is supported by the fact that CRBSI rates were <1 per 1000 catheter-days in previous studies. 5,7 Here we attempted to see at any advantage of blood culture from exit site, catheter hub, catheter tip culture versus peripheral vein blood culture.…”

Section: Discussionsupporting

confidence: 52%

“…9 10-20% CRBSI have metastatic complications like septic arthritis, endocarditis and physical loss due to catheter removal. 5 CRBSI rates can be decreased by strict aseptic handling measures of catheter by trained personnel, restricting catheter for dialysis usage alone, and early diagnosis of CRBSI to avoid complications including catheter removal which can lead to increased financial burden, morbidity and mortality. The risk of sepsis in catheter dependant dialysis patients is 50% at 6months with financial burden.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Hemodialysis catheter related blood stream infections

Subramanyam¹,

Vakrani²

2018

Int J Res Med Sci

View full text Add to dashboard Cite

Background: Hemodialysis catheter related blood stream infection (CRBSI) is common cause for sepsis in hemodialysis patients with high morbidity and mortality. It has to be diagnosed promptly for early treatment to avoid serious complications including catheter removal. This prospective study was undertaken to study clinical features, to validate use of cultures drawn from different sites for diagnosis and management of hemodialysis catheter related blood stream infection (CRBSI). As there is paucity of data regarding CRBSI, hence the study was undertaken.Methods: All hemodialysis patients with CRBSI between October 2016 to October 2017 were included. Variables like different catheter position, blood cultures collected from peripheral vein, both catheter hubs, catheter exit site swab, and catheter tip cultures were analyzed with respect to time to culture positivity, microbes and its management were analyzed.Results: Mean duration of hemodialysis catheter inside patient was 24days, most common risk factor for CRBSI was diabetes mellitus (58%) followed by surgery (50%), previous dialysis catheterization within preceding 2months (33%). 30% patients had history of guide wire exchange of catheters previously, most had temporary catheter (88%), most common site of catheter was right internal jugular vein (58%). Cultures showed gram positive organisms in 63%. It was found that same monomicrobial growth was noted in most cultures stating less chances of contamination. Exit site, catheter tip samples and blood sample from catheter’s venous hub yielded early result. It was found that same monomicrobial growth was noted in most cultures stating less chances of contamination. Among complications, 8% had endocarditis, 61% had catheter removal. Average hospital stay was 9days. Deferve scence was noted upon antibiotic therapy and catheter removal in most cases. Death was noted in 8% due to sepsis.Conclusions: CRBSI are major cause of admissions, morbidity and mortality in hemodialysis patients on catheters. Gram positive organisms were commonest pathogens causing CRBSI. Exit site, catheter tip samples and blood sample from catheter’s venous hub yielded early result. Peripheral blood sampling for culture diagnosing was unnecessary. Most requires 2-6weeks systemic antibiotics and catheter removal especially if persistent fever and systemic complications are present.

show abstract

Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Hemodialysis catheter related blood stream infections

Subramanyam¹,

Vakrani²

2018

Int J Res Med Sci

View full text Add to dashboard Cite

show abstract

“…This may be the consequence of better prevention of infections in HD patients. [35][36][37] Trends in patients with a functioning kidney transplant…”

Section: Trends In Dialysis Patientsmentioning

confidence: 99%

Data from the ERA-EDTA Registry were examined for trends in excess mortality in European adults on kidney replacement therapy

Boenink

Stel

Waldum-Grevbo

et al. 2020

Kidney International

View full text Add to dashboard Cite

atients with end-stage kidney disease are at a high risk of death. Even after starting kidney replacement therapy (KRT), half of the patients will die within 5 years. 1 On the other hand, analyses of registry data have shown that patient survival on KRT has moderately improved over the last few decades. 2-4 Part of this increase may reflect the overall increase in survival of the general population.

show abstract

“…Nevertheless, this phenomenon should be considered as an intrinsic hazard, in this study, as it is highly prevalent in the CVCs of HD patients, and this is largely documented elsewhere. 11,27 Extremely rapid innovation is occurring in the field of medical and nursing devices; hospital units are becoming even more high-tech. At the same time, the health care system expects the highest standards of nursing and outcomes in those units, as documented in the study by Saudan et al 1 Unfortunately, the literature pays little attention to how effective medical or nursing connection devices are at preventing adverse effects, their ease of use, or their safety for HD patients fitted with a CVC.…”

Section: Discussionmentioning

confidence: 99%

“…9,10 In addition, hospital admissions due to vascular-access infections have more than doubled in recent decades. 11 Obviously, CVC-related infections (CVCIs) and adverse complications have been associated with high rates of hospitalization, high treatment costs, and poor survival. 8 The incidence of CVCIs ranges between 0.6 and 6.5 episodes per 1,000 catheter days.…”

mentioning

confidence: 99%

Point prevalence of complications between the Y connection technique and the usual care technique for blood restitution in patients of an outpatient hemodialysis unit: a comparison

Tacchini-Jacquier¹,

Verloo²

2017

IJNRD

View full text Add to dashboard Cite

Background: Central venous catheter-related infections (CVCIs) in patients on maintenance hemodialysis (HD) have been documented due to unsafe/unsterile manipulations by nurses during HD machine deconnection and reconnection. Given the gravity of CVCIs in HD patients using catheter access, precise, safe installation of the device, and good nursing technique are crucial. Aim: To assess and compare safety performance and complications of a Y-connection (n=133) versus the usual tunneled central venous catheter (CVC) technique (n=73) among HD patients and then explore preferences between techniques among patients and frontline HD nurses. Materials and methods: A prospective, comparative, 3-month point prevalence survey was conducted among HD outpatients and frontline HD nurses in a 600-bed teaching hospital in the canton of Valais. Results: Nine HD outpatients (average age, 68.3 years; SD=12.3) were recruited. The two techniques showed no differences in C-reactive protein levels (p=0.465), pain (p=1.00), or local complications due to dressings soiled by exudate at the catheter insert point (p=0.066). The relative risk ratio (RR) indicated that CVCI was 1.667 times (95% CI; 0. 437, 6.358, p=0.50 (RR 0.58; [95% CI; 0.277, 1.217]; p=0.13) were significant relative risk factors for complications. Fifty-seven percent of HD patients stated that they felt more secure and comfortable using the Y-connection technique than the usual care technique. Eleven of the 12 nurses involved preferred the Y-connection technique, feeling that is was safer and easier in use. Conclusion: No difference was found in the complication rates of two blood restitution techniques -the Y-connection versus the usual CVC technique. HD outpatients and nurses preferred the Y-connection for blood restitution.

show abstract

Reducing Catheter-Related Infections in Hemodialysis Patients

Cited by 16 publications

References 33 publications

Hemodialysis catheter related blood stream infections

Hemodialysis catheter related blood stream infections

Data from the ERA-EDTA Registry were examined for trends in excess mortality in European adults on kidney replacement therapy

Point prevalence of complications between the Y connection technique and the usual care technique for blood restitution in patients of an outpatient hemodialysis unit: a comparison

Contact Info

Product

Resources

About