Incidence and risk factors for bloodstream infections stemming from temporary hemodialysis catheters

Aim: Catheter-related bloodstream infection (CR-BSI) is considered as an important complication of hemodialysis catheters. The purpose of this prospective study was to evaluate the incidence and risk factors of temporary hemodialysis catheter-related bloodstream infection.Materials and methods: Prospective data related to temporary hemodialysis catheters inserted in our institution were collected for duration of three years. The risk factors of CR-BSI of patients between the CR-BSI group and the control group were compared. Results: A total of 248 temporary hemodialysis catheters were inserted in 201 patients and remained in situ for acumulative total of 5192 catheter days. There were 3254 dialysis sessions. CR-BSI was found in 63 cases. CR-BSI rate was12.1/1000 catheter-days and 19.4/1000 dialysis sessions. In multivariate analysis, acute renal disease (OR = 2.29),administration of antibiotics at the time of catheterization (OR = 2.09), insertion in the femoral vein (OR = 2.14),emergency situation for catheter insertion (OR = 2.41), high number of catheter manipulation (OR = 2.49), and inadequate hand hygiene prior to catheter manipulations (OR = 3.02) were found to be risk factors of CR-BSI. The most frequently isolated microorganisms were coagulase-negative staphylococci (31.3%), S. aureus (26.9%), Enterococcus spp.(10.4%), and Pseudomonas aeruginosa (9.0%). Conclusion: This prospective study of temporary hemodialysis catheters has shown high rates of infectious complications.The education of both the patients and medical staff in prevention of CR-BSI is important.