Hemodialysis bloodstream infection

Abbas SA, Haloob lA, Taylor SL. et al Effect of antimicrobial locks for tunneled hemodialysis catheters on bloodstream infection and bacterial resistance a quahty improvement report. Am J Kidney Dis 2009 53 492-502. 

Delcour C, Bruninx G IncompatibiUty of contrast medium and trisodium citrate. Car-diovasc Intervent Radiol 2013 36 237-238. Camins BC, Richmond AM, Dyer KL, et al Crossover intervention trial evaluating the efficacy of a chlorhexidine-impregnated sponge in reducing catheter-related bloodstream infections among patients undergoing hemodialysis. Infect Control Hosp Epidemiol 2010 31 1118-1123. 

Hemodialysis (HD) catheter-associated bloodstream infections (BSls) are a type of CLABSI due to a central venous catheter (CVC) specifically designed for HD. In 2002, it was estimated that 50,000 CLABSIs occur in dialysis patients in the US annually. A more recent surveillance study found the rate of access-related BSIs to be 0.73 events per 100 patient-months [5]. Aside from catheters, patients in need of renal replacement therapy should eventually use arteriovenous fistula (AVF) or arteriovenous grafts (AVG) for HD, or alternatively, may receive peritoneal dialysis. All renal replacement therapies are associated with a risk of infection however, this risk varies with the method selected. Data from a CDC surveillance program display nicely how the type of access influences the BSI rate per 100 patient-months 0.5 (for AVFs), 0.9 (AVG), 4.2 (permanent CVCs), and an impressive 27.1 for temporary CVCs [6]. Another, more practi-... 

Patel PR, et al Bloodstream infection rates in outpatient hemodialysis facilities participating in a collaborative prevention effort a quality improvement report. Am J Kidney Dis 2013 62 322-330. 

Camins BC Prevention and treatment of hemodialysis-related bloodstream infections. Semin Dial 2013 26 476-481. 

Bren V. et al Getting to zero outpatient hemodialysis catheter-associated bloodstream infections in Fifth Decennial International Conference on Healthcare-Associated Infections. Atlanta, March 2010. 

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