A Comprehensive Analysis of Bloodstream Infections in Temporary Hemodialysis Catheter Patients: Incidence, Resistance, and Risk Factors

Abstract

Background: Temporary hemodialysis catheters are pivotal in managing individuals facing acute or chronic renal insufficiency, offering indispensable access to life-saving renal replacement therapy. Nonetheless, their use carries the inherent risk of bloodstream infections, a complication that can result in profound health deterioration and even fatalities. Compounding this challenge is the escalating prevalence of antibiotic-resistant bacteria, further amplifying the complexity of healthcare management in this context. Objectives: The primary aim of our investigation was to ascertain the rate of occurrence of catheter-related bloodstream infections (CRBSIs) among patients equipped with temporary hemodialysis catheters. Additionally, this study sought to delineate the antimicrobial resistance profiles of the aerobic bacterial strains implicated in these infections. A secondary goal was to unravel the risk factors predisposing patients to such infectious complications. Materials and Methods: We conducted a one-year observational study encompassing 120 patients undergoing temporary hemodialysis catheter placement. This study entailed collecting data regarding several parameters, including the cumulative days of catheter usage, occurrences of bacteremia, and the evaluation of risk factors such as age, hypoalbuminemia, duration of catheter employment, and frequency of hemodialysis sessions. Microbiological cultures from blood and pus samples were analyzed to identify the causative organisms and their antibiotic resistance profiles. Results: Throughout the study period, there were 2390 catheter days with 43 instances of laboratory-confirmed bacteremia, resulting in an infection rate of 17.9 episodes per 1000 catheter days. Older age, lower serum albumin levels, more frequent and longer hemodialysis sessions, increased catheter insertion time, and multiple insertion attempts were significant risk factors. Staphylococcus aureus was the most prevalent pathogen identified, and a high prevalence of multidrug resistance was noted among the bacterial isolates. Conclusion: The study underscores the substantial infection risk associated with temporary hemodialysis catheters and the complex interplay of patient-related and procedural risk factors. The high rate of multidrug resistance among pathogens signifies the urgency for improved infection control measures and the development of alternative strategies to manage and prevent CRBSIs in this vulnerable patient population.