Does living condition influence central line‐associated bloodstream infections and prognosis in hemodialysis patients?

Abstract

Aim/BACKGROUND: This study investigated the impact of living conditions onthe causative microorganisms of CLABSI andthe prognosis of these infections in hemodialysis patients. METHODS: Patients diagnosed with CLABSI and treated inthe last five years were retrospectively examined. The patients are divided into two groups: patients living in rural areas and living in cities. Demographic data, risk factors for infection, causative microorganisms, treatment protocols and prognoses of these patients were compared. RESULTS: A total of 300 patients were included in the study. The median age was 68 and44% were male. The most common co-morbid disease was hypertension (72%), but the most common cause of CKD was diabetes (39%). A total of 100 individuals were from rural areas. The causative microorganism could be isolated in 95% of the patients and was mostly Gram-positive bacteria (62%). Methicillin-susceptible'''' Staphylococcus aureus'''' was isolated in 85 patients, and the rate of carbapenem resistance in Gram Negative bacteria was 10%. Carbapenem + glycopeptide combination was mostly preferred as empirical treatment (19%). In 15% of patients required intensive care; Abscess, endocarditis or metastatic infection was observed in 11%. The 28-day mortality rate was 8%. No differences were observed in terms of demographic characteristics, causative microorganisms, catheter types and regions, and prognosis of patients living in rural areas and cities. The rate of femoral catheters was higher in patients living in rural areas (16% vs. 8%; p=0.008). CONCLUSIONS: The prognosis and CLABSI parameters of hemodialysis patients were similar despite differences in living conditions. Adherence to infection control measures is essential in all instances.

Keywords

• CLABSI
• hemodialysis
• Central line‐associated bloodstream infections
• living conditions