|
Infect Control Hosp Epidemiol. 2002
Dec;23(12):721-4.
Comment in: Infect Control Hosp Epidemiol.
2002 Dec;23(12):713-5.
Surveillance of hemodialysis-associated primary
bloodstream infections: the experience of ten hospital-based
centers.
Dopirak M, Hill C, Oleksiw M, Dumigan D, Arvai J, English E,
Carusillo E, Malo-Schlegel S, Richo J, Traficanti K, Welch B,
Cooper B.
Hartford Hospital, Hartford, Connecticut, USA.
OBJECTIVE: To determine baseline rates of primary bloodstream
infection (BSI) among a large pool of patients receiving
hemodialysis using standardized surveillance tools and
methodology. DESIGN: Prospective, descriptive analysis of
primary BSI rates. SETTING: Ten hospital-based hemodialysis
centers in Connecticut. PATIENTS: All patients receiving
long-term hemodialysis in the participating facilities. RESULTS:
A total of 158 BSIs occurred during 142,525 dialysis sessions
within a 12-month study period. Of the BSIs, 15.2% occurred in
patients with fistula or graft access and 84.8% in patients with
central venous catheter access (P < .001). Rates per 100
patient-years in centers ranged from 0 to 30.8, with a mean of
16.6. Rates per 1,000 dialysis sessions ranged from 0 to 2.1,
with a mean of 1.1. Coagulase-negative staphylococci and
Staphylococcus aureus (including methicillin-resistant S. aureus)
accounted for 61% and Klebsiella or Enterobacter species for
14.6% of infections. Of the patients, 63.3% received vancomycin,
24.7% received cefazolin, and 41.7% received aminoglycosides.
Rates declined in the second 6 months of the study from 1.4 to
0.8 infections per 1,000 dialysis sessions (P < .001).
CONCLUSIONS: Primary BSI rates varied widely among participating
centers and declined during the study period. BSIs were strongly
associated with central venous catheter access. Further studies
are needed to determine the reasons for variance in rates
between centers and among various types of hemodialysis access.
PMID: 12517013 [PubMed - indexed for MEDLINE]
Return to AuthorTalks
|
