Bloodstream infection in patients with end-stage renal disease in a teaching hospital in central-western Brazil
Introduction Vascular access in patients undergoing hemodialysis is considered a critical determinant of bloodstream infection (BSI) and is associated with high morbidity and mortality. The purpose of this study was to investigate the occurrence of BSI in patients with end-stage renal disease using...
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Sociedade Brasileira de Medicina Tropical (SBMT)
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ftdoajarticles:oai:doaj.org/article:132bb3e383404b74b0d171ee3ee50c4b 2023-05-15T15:11:44+02:00 Bloodstream infection in patients with end-stage renal disease in a teaching hospital in central-western Brazil Tamara Trelha Gauna Elizete Oshiro Yuri Correa Luzio Anamaria Mello Miranda Paniago Elenir Rose Jardim Cury Pontes Marilene Rodrigues Chang 2013-08-01T00:00:00Z https://doi.org/10.1590/0037-8682-0060-2013 https://doaj.org/article/132bb3e383404b74b0d171ee3ee50c4b EN eng Sociedade Brasileira de Medicina Tropical (SBMT) http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822013000400426&lng=en&tlng=en https://doaj.org/toc/1678-9849 1678-9849 doi:10.1590/0037-8682-0060-2013 https://doaj.org/article/132bb3e383404b74b0d171ee3ee50c4b Revista da Sociedade Brasileira de Medicina Tropical, Vol 46, Iss 4, Pp 426-432 (2013) Catheter Bloodstream infection Chronic renal patients Bacteremia Hemodialysis Arctic medicine. Tropical medicine RC955-962 article 2013 ftdoajarticles https://doi.org/10.1590/0037-8682-0060-2013 2022-12-30T21:26:05Z Introduction Vascular access in patients undergoing hemodialysis is considered a critical determinant of bloodstream infection (BSI) and is associated with high morbidity and mortality. The purpose of this study was to investigate the occurrence of BSI in patients with end-stage renal disease using central venous catheters for hemodialysis. Methods A cohort study was conducted in a public teaching hospital in central-western Brazil from April 2010 to December 2011. For every patient, we noted the presence of hyperemia/exudation upon catheter insertion, as well as fever, shivering, and chills during hemodialysis. Results Fifty-nine patients were evaluated. Thirty-five (59.3%) patients started dialysis due to urgency, 37 (62.7%) had BSI, and 12 (20%) died. Hyperemia at the catheter insertion site (64.9%) was a significant clinical manifestation in patients with BSI. Statistical analysis revealed 1.7 times more cases of BSI in patients with hypoalbuminemia compared with patients with normal albumin levels. The principal infective agents identified in blood cultures and catheter-tip cultures were Staphylococcus species (24 cases), non-fermentative Gram-negative bacilli (7 cases of Stenotrophomonas maltophilia and 5 cases of Chryseobacterium indologenes), and Candida species (6). Among the Staphylococci identified, 77.7% were methicillin-resistant, coagulase-negative Staphylococci. Of the bacteria isolated, the most resistant were Chryseobacterium indologenes and Acinetobacter baumannii. Conclusions Blood culture was demonstrated to be an important diagnostic test and identified over 50% of positive BSI cases. The high frequency of BSI and the isolation of multiresistant bacteria were disturbing findings. Staphylococcus aureus was the most frequently isolated microorganism, although Gram-negative bacteria predominated overall. These results highlight the importance of infection prevention and control measures in dialysis units. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Revista da Sociedade Brasileira de Medicina Tropical 46 4 426 432 |
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Directory of Open Access Journals: DOAJ Articles |
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English |
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Catheter Bloodstream infection Chronic renal patients Bacteremia Hemodialysis Arctic medicine. Tropical medicine RC955-962 |
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Catheter Bloodstream infection Chronic renal patients Bacteremia Hemodialysis Arctic medicine. Tropical medicine RC955-962 Tamara Trelha Gauna Elizete Oshiro Yuri Correa Luzio Anamaria Mello Miranda Paniago Elenir Rose Jardim Cury Pontes Marilene Rodrigues Chang Bloodstream infection in patients with end-stage renal disease in a teaching hospital in central-western Brazil |
topic_facet |
Catheter Bloodstream infection Chronic renal patients Bacteremia Hemodialysis Arctic medicine. Tropical medicine RC955-962 |
description |
Introduction Vascular access in patients undergoing hemodialysis is considered a critical determinant of bloodstream infection (BSI) and is associated with high morbidity and mortality. The purpose of this study was to investigate the occurrence of BSI in patients with end-stage renal disease using central venous catheters for hemodialysis. Methods A cohort study was conducted in a public teaching hospital in central-western Brazil from April 2010 to December 2011. For every patient, we noted the presence of hyperemia/exudation upon catheter insertion, as well as fever, shivering, and chills during hemodialysis. Results Fifty-nine patients were evaluated. Thirty-five (59.3%) patients started dialysis due to urgency, 37 (62.7%) had BSI, and 12 (20%) died. Hyperemia at the catheter insertion site (64.9%) was a significant clinical manifestation in patients with BSI. Statistical analysis revealed 1.7 times more cases of BSI in patients with hypoalbuminemia compared with patients with normal albumin levels. The principal infective agents identified in blood cultures and catheter-tip cultures were Staphylococcus species (24 cases), non-fermentative Gram-negative bacilli (7 cases of Stenotrophomonas maltophilia and 5 cases of Chryseobacterium indologenes), and Candida species (6). Among the Staphylococci identified, 77.7% were methicillin-resistant, coagulase-negative Staphylococci. Of the bacteria isolated, the most resistant were Chryseobacterium indologenes and Acinetobacter baumannii. Conclusions Blood culture was demonstrated to be an important diagnostic test and identified over 50% of positive BSI cases. The high frequency of BSI and the isolation of multiresistant bacteria were disturbing findings. Staphylococcus aureus was the most frequently isolated microorganism, although Gram-negative bacteria predominated overall. These results highlight the importance of infection prevention and control measures in dialysis units. |
format |
Article in Journal/Newspaper |
author |
Tamara Trelha Gauna Elizete Oshiro Yuri Correa Luzio Anamaria Mello Miranda Paniago Elenir Rose Jardim Cury Pontes Marilene Rodrigues Chang |
author_facet |
Tamara Trelha Gauna Elizete Oshiro Yuri Correa Luzio Anamaria Mello Miranda Paniago Elenir Rose Jardim Cury Pontes Marilene Rodrigues Chang |
author_sort |
Tamara Trelha Gauna |
title |
Bloodstream infection in patients with end-stage renal disease in a teaching hospital in central-western Brazil |
title_short |
Bloodstream infection in patients with end-stage renal disease in a teaching hospital in central-western Brazil |
title_full |
Bloodstream infection in patients with end-stage renal disease in a teaching hospital in central-western Brazil |
title_fullStr |
Bloodstream infection in patients with end-stage renal disease in a teaching hospital in central-western Brazil |
title_full_unstemmed |
Bloodstream infection in patients with end-stage renal disease in a teaching hospital in central-western Brazil |
title_sort |
bloodstream infection in patients with end-stage renal disease in a teaching hospital in central-western brazil |
publisher |
Sociedade Brasileira de Medicina Tropical (SBMT) |
publishDate |
2013 |
url |
https://doi.org/10.1590/0037-8682-0060-2013 https://doaj.org/article/132bb3e383404b74b0d171ee3ee50c4b |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista da Sociedade Brasileira de Medicina Tropical, Vol 46, Iss 4, Pp 426-432 (2013) |
op_relation |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822013000400426&lng=en&tlng=en https://doaj.org/toc/1678-9849 1678-9849 doi:10.1590/0037-8682-0060-2013 https://doaj.org/article/132bb3e383404b74b0d171ee3ee50c4b |
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https://doi.org/10.1590/0037-8682-0060-2013 |
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Revista da Sociedade Brasileira de Medicina Tropical |
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46 |
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426 |
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