Original scientific paper
TUNNELED CATHETER INFECTIONS IN PATIENTS ON HEMODIALYSIS – ONE CENTER EXPERIENCE
HALIMA RESIĆ
; Clinic for Hemodialysis, Clinical center university of Sarajevo, Sarajevo, Bosni and Herzegovina
SELMA AJANOVIĆ
; Clinic for Hemodialysis, Clinical center university of Sarajevo, Sarajevo, Bosni and Herzegovina
NIHAD KUKAVICA
; Clinic for Hemodialysis, Clinical center university of Sarajevo, Sarajevo, Bosni and Herzegovina
AIDA ĆORIĆ
; Clinic for Hemodialysis, Clinical center university of Sarajevo, Sarajevo, Bosni and Herzegovina
FAHRUDIN MAŠNIĆ
; Clinic for Hemodialysis, Clinical center university of Sarajevo, Sarajevo, Bosni and Herzegovina
AMELA BEĆIRAGIĆ
; Clinic for Hemodialysis, Clinical center university of Sarajevo, Sarajevo, Bosni and Herzegovina
Abstract
Use temporary and tunneled catheters for hemodialysis treatment. the presence of the catheter, increases the risk of bacteremia in hemodialysis patients. risk factors are nasal colonization with staphylococcus aureus, prolonged use of catheters, previous bacteremia,
anover dose of iron, low hemoglobin, low albumins, diabetes mellitus, and surgical procedures. the aim of this study was prevention of catheter sepsis and timely disclosures of existing and effective cures. Patientsand methods: thirty-eight patients with tunnelled catheters as vascular access for hemodialysis were included into the study. the study was conducted between january 1, 2011 and january 3, 2012. outof 38 patients, 60% (23) were male and 40% (15) were female,while the average age was 67.48±13.9 years. the duration of emodialysis treatment was 108.9 ±16.54 months. results: over the study period, 9 patients developed bacteriemia associated with the use of catheter as a vascular approach. The incidence of infection in our study was 3.5 cases per 1000 catheter days. two patients (5.2%) developed an infection in the first three months after the day of catheter placement, and the remaining 6 (15.8%) patients after one year of the use of catheter as a vascular approach. regarding the causesof infection, in 3 (33%) patients these were gram-positive pathogens, in 5 (56%) patients gram-negative pathogens, and in one (11%) patient it was polimicrobe flora. according to the protocol and pending the outcome of susceptibility testing (antibiogram), all the patients were prescribed with antibiotic treatment therapy. in 7 (75%) patients tunnelled catheter was removed and replaced with temporary catheters for hemodialysis treatment.
in 2(25%) patients, was antibiotic-lock solution was injected into the catheter. there were no significant differences (p <0.05) in age, duration of dialysis treatment, hemoglobin levels, iron, transferrin saturation, ferritin and albumin in patients without infection and those
who developed aninfection. only one patient has had a nasal colonization with staphylococcus aureus. one patient developed severe thrombocytopenia, followed by sepsis anda lethal outcome due to heavy gastrointestinal bleeding. conclusion: tunneled venous catheter
is the increasingly common vascular access with the hemodialytic patients, but it is also a common cause of infection. Proper care and use of catheters, making the unique protocols of care and treatment algorithm occupy a significant place in each hemodialysis
center. our goal is to prevent the catheter sepsis, and to promptly detect the existing and a fast treatment of the same.
Keywords
hemodialysis; central venous catheter for hemodialysis; antibiotic lock solution
Hrčak ID:
99534
URI
Publication date:
3.4.2013.
Visits: 2.833 *