Details

Autor(en) / Beteiligte

• Brañas, Patricia, PhD
• Morales, Enrique, MD
• Ríos, Francisco, MD
• Sanz, Francisca, MD
• Gutiérrez, Eduardo, MD
• Quintanilla, Nuria, MD
• Orellana, M. Angeles, MD, PhD
• Sánchez, Mercedes, MD
• Rodríguez-Aranda, Almudena, PhD
• Chaves, Fernando, MD, PhD

Titel

Usefulness of endoluminal catheter colonization surveillance cultures to reduce catheter-related bloodstream infections in hemodialysis

Ist Teil von

• American journal of infection control, 2014-11, Vol.42 (11), p.1182-1187

Ort / Verlag

New York, NY: Elsevier Inc

Erscheinungsjahr

2014

Quelle

Elsevier ScienceDirect Journals

Beschreibungen/Notizen

• Background To evaluate the use of surveillance cultures (SCs) to prevent catheter-related bloodstream infections (CRBSIs) in asymptomatic hemodialysis (HD) patients. Methods In 2011-2012, we conducted a prospective study of HD patients with tunneled cuffed central venous catheters (TCCs). Colonization of the catheter lumen was assessed every 15 days by inoculating ∼5 mL endoluminal blood into aerobic culture bottles. Individual patients were triaged based on SC results: group 1 (negative); group 2 (coagulase-negative Staphylococcus [CoNS] with time-to-positivity (TTP) >14 hours); group 3 (CoNS with TTP ≤14 hours); and group 4 (any microorganism other than CoNS and any TTP). Results We studied 104 patients (129 TCCs). Median follow-up was 262.5 days (interquartile range [IR], 135.0-365.0). A total of 1,734 SCs were collected (median, 18 per patient; IR, 10.0-24.0), of which 1,634 (94.2%) were negative (group 1) and 100 (5.8%) were positive (group 2: 79; group 3: 12, group 4: 9). In groups 2 and 3, 19 TCCs required antibiotic lock therapy (ALT). In group 4, all patients received intravenous therapy and ALT. Under this protocol, there were 0.27 episodes of CRBSI per 1,000 catheter days compared with 1.65 ( P  < .001) prior to its implementation. Conclusion SCs based on easily accessible samples proved useful in triaging HD patients at a high risk of infection.