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Year : 2021  |  Volume : 14  |  Issue : 4  |  Page : 179-183

The rate of catheter-related bloodstream infection in renal dialysis patients using central venous catheters: A retrospective study

1 Department of Internal Medicine, Tawam Hospital, Al Ain, UAE
2 University of Sharjah, Sharjah, UAE
3 Dialysis Unit, SEHA Dialysis Services, Al Ain, UAE
4 Department of Internal Medicine, Tawam Hospital; Division of Infectious Diseases, Tawam Hospital, Al Ain, UAE
5 Department of Internal Medicine, Tawam Hospital; Division of Nephrology, Tawam Hospital, Al Ain, UAE

Correspondence Address:
Khaled Karkout
Department of Internal Medicine, Tawam Hospital, Al Ain
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/hmj.hmj_22_21

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Background: Globally, haemodialysis patients using central venous catheters remain at a huge risk for blood stream infections. Most of these infections are caused by skin dormant organisms. Patients suffering from blood stream infections have the risk of seeding the infection into distant organs leading to multiple organ failure, fulminant shock and death. Objectives: our primary objective is to calculate the rate of catheter related blood stream infections (CRBSI) in patients inevitably using central venous catheters (CVC) while waiting for their arteriovenous fistula (AVF) maturation, and compare it to the international benchmark. Our secondary objective is to compare the morbidity and mortality outcomes between patients using central venous catheters vs. patients with arteriovenous fistula. Methods: A retrospective single centre study on Tawam hospital outpatient dialysis patients, who underwent dialysis at the SEHA dialysis service (SDS) centre. Data were obtained from 1st January 2015 till 30th Dec 2015. We only included patients needed to temporarily use CVC while waiting for their AV maturation. Data were obtained from Electronic Medical Records, and analysed using SPSS. Results: The total study population was 219 patients, of them; 175 patients of them were using a CVC for their first haemodialysis session. Out of patients using CVC, 53 (30.3%) patients were admitted at least once for an episode of infection during the first year of initiation of dialysis. The number of overall admission days were higher in the CVC group (2172 days) when compared to patients who started their haemodialysis with AVF directly without using CVC initially (588 days). The rate of CRBSI in our patients using CVC temporarily appeared to be 5.2 episodes per 1000 catheter-days. The number of interventional radiology procedures needed were significantly higher in the patients using CVC. There were 16 mortality cases, of which 15 (93.8%) were in the group using CVC. Conclusion: Dialysis through central venous catheter showed to have an increase in the number of admission days (overall and related to CRBSI), morbidity and mortality when compared to arteriovenous fistula. In the light of these findings, the decision of either waiting for fistula maturation or using CVC temporarily should be carefully tailored on case by case basis. Quality improvement projects are needed to address this important problem hospital wide. Decreasing hospitalization decreases the burden and the stretch on health care services and allows to provide better patient centred care.

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