Original article
English
Al-Ghaweel I 1, Ezwaie MO 2, Zahid IH 3, Hussain SM 2, Elferjani NI 4
1-Department of Community Medicine, Faculty of Medicine, Al-Arab Medical University 2-Nephrology Centre, Department of Medicine, Al-Arab Medical University 3-Department of Environment, Faculty of Public Health, Al-Arab Medical University 4-Nephrology Centre, Academy of Higher Education, Benghazi-Libya.
Libyan J Infect Dis. 2008;2(2):25-30
Abstract
Background/Aims: Continuous haemodialysis is commonly used in patients with end stage renal disease. Catheter- related bacteraemia (CRB) is a major cause of morbidity in haemodialysis patients. This retrospective study was carried out to determine the incidence, clinical profile and morbidity and mortality of CRB in Benghazi Nephrology Centre.
Materials and Methods: All hospital records of hemodialysis patients with catheters placed in hemodialysis Unit at Benghazi Nephrology Centre in the period of 1st January 2003 through 31st December 2006 were retrospectively analysed for CRB. In all cases, pyrexia in patients with central venous catheters was considered to be due to CRB until proved otherwise. Catheter was taken out, even in case of permanent (tunnelled) one, and the tip was sent for culture and sensitivity.
Results: The mean age ±SD of hemodialysis patients was 56± 10.4 years (range=26-70 years) and the male to female ratio was 1:3:1. The overall incidence of CRB was 5.7 episodes per 1000 catheters – days. Staphylococcus species were the most predominant pathogens isolated. Two patients died due to septicaemia and one patient had meningitis due to Gram-negative bacteria. Antimicrobial therapy with vancomycin, ceftriaxone and gentamicin was effective in 91% of CRB cases.
Conclusion: The present study has shown that CRB is not uncommon complication in patients using dialysis catheters at Benghazi Nephrology Centre. However, it occurs less commonly with tunnelled than non-tunnelled central venous catheters Staphylococcus spp. Being the most commonly isolated pathogens, antimicrobial therapy should cover Staphylococcus species unless culture result indicates otherwise.
Keywords: Central venous catheters, catheter-related bacteraemia, Staphylococcus, hemodialysis therapy
Link/DOI: http://www.nidcc-jid.org.ly/pdf/v2no2/original_article_retrospective_analysis_catheter.pdf