[an error occurred while processing this directive]

Analysis of catheter-related bloodstream infections on seasonal prevalence, pathogen characteristics, and drug sensitivity in maintenance hemodialysis patients

  • ZHANG Yan ,
  • GAO Zhi-Wei ,
  • LIAN Xiu-Hua ,
  • WANG Zun-Song
Expand
  • Hemodialysis Division and 2Department of Nephrology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan 250014, China

Received date: 2024-04-07

  Revised date: 2024-09-18

  Online published: 2024-12-12

Abstract

Objective  To analyze the seasonal prevalence, pathogen characteristics, and drug sensitivity of catheter-related blood stream infection (CRBSI) in maintenance hemodialysis (MHD) patients.  Method  A retrospective analysis was conducted on the patients treated with tunnel-cuffed catheter (TCC) insertion surgery for MHD at the Department of Nephrology, The First Affiliated Hospital of Shandong First Medical University from August 2012 to June 2021. CRBSI happened in a total of 62 hospitalized patients, including 48 patients with defined pathogenic bacteria from blood cultures. Their infection season, pathogenic bacterial characteristics and drug sensitivity were analyzed.  Results  CRBSI occurred higher in spring and summer (38 cases, 61.3%) than in autumn and winter (24 cases, 38.7%) (c2=6.323, P=0.012). Gram positive bacteria accounted for 52.9%, and Gram negative bacteria for 45.1%. More than half of the Gram positive bacteria were staphylococcus aureus (63.0%), followed by staphylococcus epidermidis (22.2%). Many types of Gram negative bacteria caused the CRBSI, and Escherichia coli accounted for 21.7% of Gram negative bacteria. Antibiotics sensitive to Gram positive bacteria included vancomycin, teicoplanin, tigecycline, antibiotics with higher resistance rates included penicillin G, erythromycin, and clindamycin. Antibiotics sensitive to gram-negative bacteria included ertapenem, piperacillin/tazobactam, cefoperazone/sulbactam, antibiotics with higher resistance rates included ampicillin and cefazolin.  Conclusion  The incidence of CRBSI is higher in spring and summer. Staphylococcus aureus and staphylococcus epidermidis account for the vast majority of Gram positive bacteria. Many types of Gram negative bacteria are involved in CRBSI, with Escherichia coli being the most common bacterium. When the use of special grade antibiotics is restricted, moxifloxacin combined with piperacillin/tazobactam or cefoperazone/sulbactam can be considered as an empirical antibiotic treatment option for CRBSI.

Cite this article

ZHANG Yan , GAO Zhi-Wei , LIAN Xiu-Hua , WANG Zun-Song . Analysis of catheter-related bloodstream infections on seasonal prevalence, pathogen characteristics, and drug sensitivity in maintenance hemodialysis patients[J]. Chinese Journal of Blood Purification, 2024 , 23(12) : 943 -946 . DOI: 10.3969/j.issn.1671-4091.2024.12.013

References

[1]Wang F, Yang C, Long J, et al. Executive summary for the 2015 Annual Data Report of?the China Kidney Disease Network (CK-NET) [published correction appears in Kidney Int. 2019 Aug;96(2):525].?Kidney Int. 2019;95(3):501-505.
[2]金其庄, 王玉柱, 叶朝阳,等.中国血液透析用血管通路专家共识(第 2 版)[J]. 中国血液净化, 2019, 018(006):365-381.
[3]Pisoni RL, Zepel L, Port FK, Robinson BM. Trends in US Vascular Access Use, Patient Preferences, and Related Practices: An Update From the US DOPPS Practice Monitor With International Comparisons.?Am J Kidney Dis. 2015;65(6):905-915.
[4] DeSilva RN, Patibandla BK, Vin Y, et al. Fistula first is not always the best strategy for the elderly.?J Am Soc Nephrol. 2013;24(8):1297-1304.
[5]于澈,王荣.老年血液透析患者通路的现状与思考[J].中国血液净化,2015,14(01):51-53+56.
[6]Schwanke AA, Danski MTR, Pontes L, Kusma SZ, Lind J. Central venous catheter for hemodialysis: incidence of infection and risk factors.?Rev Bras Enferm. 2018;71(3):1115-1121.
[7]Tanriover B, Carlton D, Saddekni S, et al. Bacteremia associated with tunneled dialysis catheters: comparison of two treatment strategies.?Kidney Int. 2000;57(5):2151-2155.
[8]Allon M. Dialysis catheter-related bacteremia: treatment and prophylaxis.?Am J Kidney Dis. 2004;44(5):779-791.
[9] Maraj S, Jacobs LE, Kung SC, et al. Epidemiology and outcome of infective endocarditis in hemodialysis patients.?Am J Med Sci. 2002;324(5):254-260.
[10] 杨芳芳.终末期肾脏病血液透析导管相关血流感染的临床特征分析[J].临床检验杂志(电子版),2019,8(4):243—244
[11] 陈晓君,袁咏梅,徐晓耘,等.某三甲医院ICU下呼吸道感染病原学特点及危险因素[J].江苏预防医学,2020,31(2):142—144,155.
[12]吴超,张永根,杨坚.萍乡市某医院ICU收治的60例重症感染患者病原菌分布及耐药状况[J].江苏预防医学,2020,31(01):61-62+79.
[13]张伟,赵若冰,周燕等.血液透析患者导管相关性血流感染风险预测模型的系统评价[J].中国血液净化,2024,23(03):204-208.
[14]Su LT, Huang HC, Liu YC, et al. The appropriate frequency of dressing for percutaneous central venous catheters in preventing catheter-related blood stream infection in NICU - A randomized controlled trial.?Pediatr Neonatol. 2021;62(3):292-297.
[15] Shingarev R, Barker-Finkel J, Allon M. Natural history of tunneled dialysis catheters placed for hemodialysis initiation.?J Vasc Interv Radiol. 2013;24(9):1289-1294.
[16]高志华.血液透析患者中心静脉导管相关性血流感染的危险因素及耐药性分析[D].吉林大学,2015.
[17]Lok CE, Thumma JR, McCullough KP, et al. Catheter-related infection and septicemia: impact of seasonality and modifiable practices from the DOPPS.?Semin Dial. 2014;27(1):72-77.
[18] 王素琴,赖亚云,林毕群,等.梅雨季节血液透析患者易发生长期留置导管感染的原因分析及对策[J].现代实用医学,2012, 24(11):2.
[19] 黄辉萍,连羡玉,秦维霞.综合医院医务人员手卫生依从性现状调查[J].中华医院感染学杂志,2010,20(21):3344-3346.
[20] 振声,金大鹏,陈增辉.医院感染管理学[M].北京:军事医学科学出版社,2000:739—741.
[21] 蒋萍,张敏,孙淑华.我院实施静脉治疗护理质量控制的实践及效果[J].护理管理杂志,2005(08):25-26.
[22] Farrington CA, Allon M. Management of the Hemodialysis Patient with Catheter-Related Bloodstream Infection.?Clin J Am Soc Nephrol. 2019;14(4):611-613.
[23] 美国 NKF-K/DOQI 工作组.慢性肾脏病及透析的临床实践指南[M].人民卫生出版社, 2005.
[24] Al-Solaiman Y, Estrada E, Allon M. The spectrum of infections in catheter-dependent hemodialysis patients.?Clin J Am Soc Nephrol. 2011;6(9):2247-2252.
[25] Stryjewski ME, Szczech LA, Benjamin DK Jr, et al. Use of vancomycin or first-generation cephalosporins for the treatment of hemodialysis-dependent patients with methicillin-susceptible Staphylococcus aureus bacteremia.?Clin Infect Dis. 2007;44(2):190-196.
[26] 祁兴敏.某医院 2018—2020 年血液净化患者导管相关性感染情况及影响因素[J].江苏预防医学,2021,32(2):3.
[27]王俊,高凯杰,张玲.2015—2017 年某儿童医院耐碳青霉烯类肠 杆菌科细菌分布及耐药性分析[J].中国抗生素杂志,2019,44(7):860—863.
Outlines

/

[an error occurred while processing this directive]