Korean J Nosocomial Infect Control.  2005 Jun;10(1):19-31.

A Study of the Bloodstream Infections in one University Hospital Hemodialysis Patients

• Lee J
• Kim S
• Jeong J

Abstract

BACKGROUND: Hemodialysis patients are increasing every year and bloodstream infections (BSIs) are a major cause of morbidity and mortality in patients receiving hemodialysis. As the domestic studies have not explored the incidence of BSIs, the distribution and current situation of microorganism and so on this study was carried out to determine the incidence and epidemiological risk factors of the BSIs in hemodialysis patients. A distribution of pathogenic organism of the BSIs was investigated.
METHODS
This study was carried out for those 275 patients with hemodialysis for 12 months the patients who underwent hemodialysis in the hemodialysis center within the university hospital. Data was collected by structural questionnaire, medical record review. The definition for BSIs was based on that of CDC.
RESULTS
A total of 59 BSIs occurred during 123,502 dialysis sessions. The bloodstream infection rate per 1,000 dialysis sessions was 0.48 overall and varied markedly by the type of vascular access: 0.1 for arteriovenous fistulas, 0.54 for arteriovenous grafts. 2.57 for permanent catheters and 5.39 for temporary catheters. The most common pathogen isolated from the BSIs was MSSA and MRSA 18.0%, Streptococcus species 11.5%. In a logistic regression analysis, immunosuppressive therapy (OR=8.081, p=0.001), case of starting hemodialysis in the intensive care unit (OR=4.855, p=0.043) were associated independently with BSIs.
CONCLUSION
Based on this study, continuous study and effort together with interest in BSIs, and the study on BSIs in hemodialysis patients should be further continued in the years to come. Surveillance for BSIs is recommended as a routine activity in hemodialysis center.

Keyword

Hemodialysis; Nosocomial infection; Bacteremia

MeSH Terms

Arteriovenous Fistula
Bacteremia
Catheters
Centers for Disease Control and Prevention (U.S.)
Cross Infection
Dialysis
Humans
Incidence
Intensive Care Units
Logistic Models
Medical Records
Methicillin-Resistant Staphylococcus aureus
Mortality
Renal Dialysis*
Risk Factors
Streptococcus
Transplants
Surveys and Questionnaires