Clinical features of hemodialysis catheter related infections in end stage renal disease

ZHENG Ting; GAO Zhao; CAI Yini; YANG Dingping

doi:10.3969/j.issn.1671-6450.2018.07.009

Abstract：Objective To investigate the causes,risk factors,drug sensitivity test and clinical outcome of hemodialysis catheter related bloodstream infections (CRBSI) and provide a theoretical basis for prevention and treatment of CRBSI. Meth-ods Clinical data of ESRD patients receiving hemodialysis in Department of nephrology of Renmin Hospital of Wuhan Univer-sity from Nov,2014 to Nov,2017 were retrospectively analyzed. The causes,pathogenic bacteria,drug sensitivity and clinical outcome of CRBSI were analyzed. Results The main causes of CRBSI include: non-standard central venous catheterization care,catheter slippage and poor drainage of the catheter. In the total of 72 blood culture, 49 cases (68. 06% ) were infected with Gram positive cocci,18 cases (25. 00% ) with Gram negative bacillus, and 1 case (1. 39% ) with fungi. Drug sensitivity test showed that Gram positive cocci had the resistance rate to penicillin (95. 00% ) and ampicillin (70. 00% ), but was sen-sitive to vancomycin and teicoplanin in all cases. The resistance rate of Gram negative bacillus to Amoxicillin and Clavulanate Potassium, Ampicillin and Sulbactam were 63. 64% and 62. 50% ,no resistance was found to Colistin and Tetracycline. Con-clusion The main causes of CRBSI in hemodialysis patients in our center are non-standard fluid handling, slippage of the catheter, poor drainage of the catheter. PCT and ALB are related risk factors for CRBSI. PCT is not only one of the diagnostic criteria for CRBSI, but also an important indicator for assessing the severity of the infection. The main pathogen of hemodialy-sis catheter related bloodstream infections is Gram positive bacteria,no resistance was found to Colistin and Tetracycline.