Vascular access types in hemodialysis patients in palestine and factors affecting their distribution: A cross-sectional study

Hamdan, Zakaria; As'ad, Nihad; Sawalmeh, Osama; Shraim, Mujahed; Kukhon, Faeq

doi:10.4103/1319-2442.252907

Cited by 5 publications

(1 citation statement)

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“…En este estudio, el sitio de inserción que más se utilizó para la colocación del CVC para HD se localizó en la vena yugular interna en más de la mitad de la población y con menor frecuencia la vena yugular externa izquierda y la subclavia, dichos resultados difieren de lo encontrado por investigadores donde el sitio de inserción del CVC fue la vena subclavia como sitio más frecuente, seguido de la yugular interna y la femoral (24) , otro estudio reportó que se colocaron los CVC en vena yugular interna derecha, en yugular interna izquierda, en femoral derecha y el restante en la yugular (25) . Diversos autores (24,25) mencionaron que independiente del lugar reportaron el desarrollo de infección relacionada con el CVC, sin embargo, una de las variables que en ambos estudios incluyeron fue el tiempo de uso del CVC, variable que en este estudio no se reportó.…”

Section: Discussionunclassified

Infecciones asociadas a catéter venoso central en adultos en proceso de hemodiálisis

Silva-Cázares,

Escamilla-Reta,

Lozano-Zúñiga

et al. 2023

SANUS

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Introducción: El catéter venoso central utilizado para hemodiálisis es la alternativa para los pacientes que se encuentran padeciendo insuficiencia renal crónica, en donde intervienen los profesionales de enfermería. Objetivo: Identificar la prevalencia de infecciones relacionada al catéter venoso central en pacientes con hemodiálisis de una clínica en México. Metodología: Estudio cuantitativo retrospectivo y descriptivo. La fuente de información fueron expedientes de la población total de pacientes atendidos en el año 2018 que correspondió a 29 usuarios y acciones epidemiológicas realizadas en el periodo de estudio y resultados reportadas en la bitácora de jefe de enfermería del área de hemodiálisis Resultados: Se encontró con un 43% staphylococcus epidermidis, el 14% de los casos de bacteriemia relacionada a catéter fue relacionada a bacteriemias nosocomiales; Se realizó cultivo de manos de todo el personal de enfermería en los diferentes turnos reportando la presencia de staphylococcus epidermidis en 60% del personal y staphylococcus coagulasa negativa en 60% del mobiliario del área de hemodiálisis. Conclusión: Se evidenció la necesidad de reforzar las medidas la prevención de infecciones relacionadas al catéter venoso central en los procedimientos de manipulación, incluyendo la unificación de los protocolos de asepsia y manejo de accesos vasculares permanentes por el personal de la salud.

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Section: Discussionunclassified

Infecciones asociadas a catéter venoso central en adultos en proceso de hemodiálisis

Silva-Cázares,

Escamilla-Reta,

Lozano-Zúñiga

et al. 2023

SANUS

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Patterns of microbial resistance in bloodstream infections of hemodialysis patients: a cross-sectional study from Palestine

Abutaha

Al-Kharraz

Belkebir

et al. 2022

Sci Rep

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Bloodstream infections (BSIs) are a prominent cause of death and hospitalization among hemodialysis (HD) patients. The emergence of multidrug-resistant organisms (MDRO) is making the management of these infections more challenging. This study describes the clinical characteristics, microbial profiles and antibiotic resistance patterns in patients with BSIs. A retrospective cross-sectional study was conducted at An-Najah National University Hospital from January 2019 to December 2020. Clinical and demographic data regarding BSIs were collected from the hospital information system. Data regarding bacterial isolates and the antimicrobial resistance of BSIs were collected from the microbiology lab. Data were entered and analyzed using version 21 of the Statistical Package for Social Sciences program (IBM-SPSS). 111 BSIs occurred during the study period, with a rate of 1.5 infections per 100 patient-months. These patients had been on HD for the median duration of 747 (360, 1825) days and 62.2% had already had a BSI before the study period. 118 microorganisms were isolated; 99 (83.89%) were gram-positive and 19 (16.1%) were gram-negative. Among the gram-positive isolates, coagulase-negative staphylococci (CoNS) (88, 74.57%) were predominant. As for the gram-negative isolates, the most frequent were both Stenotrophomonas maltophilia and Escherichia coli, with five (4.23%) positive cultures each. Among the latter, two were Extended-Spectrum Beta-Lactamase producing (ESBL) (1.69%). The most frequently used empiric antibiotics were a combination of vancomycin and gentamicin (27%), followed by vancomycin alone (24.3%). Regarding gram-positive isolates, vancomycin was the most frequently used and effective antibiotic after cultures, whereas for gram-negative bacteria, it was found to be gentamicin. MDROs were defined as those resistant to at least one agent in three or more antimicrobial categories. 89 (75.4%) isolates were found to be MDRO, 85 (85.85%) gram-positive bacteria and 4 (21%) gram-negative bacteria. When comparing patients according to the type of vascular access, 66 (75%) infections with MDRO were found among patients with central venous catheters (CVCs). However, no statistically significant relationship was found between the type of vascular access and infection with MDRO (p = 0.523). MDRO cause a remarkably high proportion of BSIs in Palestinian patients. The results of this study support the empiric use of vancomycin and gentamicin to treat these infections. It is vital that health care providers prevent these infections via instituting and adhering to infection control policies in hemodialysis centers and providing proper antibiotic therapy of limited use and duration when necessary to avoid breeding resistance.

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Predialysis nephrology care amongst Palestinian hemodialysis patients and its impact on initial vascular access type

et al. 2020

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Referral time for end-stage renal disease (ESRD) patients to nephrologists and initial vascular access method are considered significant factors that impact health outcomes at the time of hemodialysis (HD) initiation. Native arteriovenous fistula (AVF) is strongly recommended as initial access. However, little is known about the referral rate among ESRD receiving HD in Palestine and its correlation with AVF creation. In Ramallah Hemodialysis Center, we investigated the predialysis nephrology care and AVF usage in 156 patients. Type of access at HD initiation was temporary central venous catheter (CVC) in 114 (73%), tunneled hemodialysis catheter (TDC) in 21 (13%) and AVF in 21 (13%). Out of all participants, 120 (77%) were seen by nephrologist prior to dialysis. Of the participants who initiated dialysis with a CVC, 36 (31%) had not received prior nephrology care. All participants who initiated dialysis with functional AVF had received prior nephrology care. Patients who were not seen by a nephrologist prior to HD initiation had no chance at starting HD with AVF, whereas 17% of those who had nephrology care >12 months started with AVF. In conclusion, a relatively large percentage of Palestinian HD patients who were maintained on HD did not have any predialysis nephrology care. In addition, patients who received predialysis nephrology care were significantly more likely to start their HD through AVF whereas all those without predialysis nephrology care started through CVC. More in-depth national studies focusing on improving nephrology referral in ESRD patients are needed to increase AVF utilization.

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Vascular access types in hemodialysis patients in palestine and factors affecting their distribution: A cross-sectional study

Cited by 5 publications

References 0 publications

Infecciones asociadas a catéter venoso central en adultos en proceso de hemodiálisis

Infecciones asociadas a catéter venoso central en adultos en proceso de hemodiálisis

Patterns of microbial resistance in bloodstream infections of hemodialysis patients: a cross-sectional study from Palestine

Predialysis nephrology care amongst Palestinian hemodialysis patients and its impact on initial vascular access type

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