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Revista de Nefrología, Diálisis y Trasplante

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2022, Number 4

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Rev Nefrol Dial Traspl 2022; 42 (4)

Influence of management variables of tunneled venous catheters in hemodialysis on the bacteremia rate: Observational analytical study

Gimeno HV, Beneit MJV, Faraldo CA, Herrero CJA, Zaragoza GI, López MV, Lope ATE, Ortuño SI
Full text How to cite this article

Language: Spanish
References: 31
Page: 285-295
PDF size: 225.32 Kb.


Key words:

Tunneled Central Venous Catheter (CVCT), Bacteremia, Nursing (Desh), Care (Desh), hemodialysis.

ABSTRACT

Introduction: Central venous catheter (CVC)-related infection is the most frequent and serious complication in hemodialysis patients, associated with high mortality and morbidity. In Spain, an incidence of bacteremia of 0.9 to 2 episodes per catheter and year has been published. Variables have been related to the rate of bacteremia associated with CVC, such as catheter malfunctions, the training and experience of the nursing, the number of hemodialysis sessions and their duration. The objective of the present study is to analyze the influence of the aforementioned variables on the appearance of bacteremia in patients with catheters in a hemodialysis unit of a tertiary care hospital in Spain. Methods: Analytical, observational, and retrospective study in which data on the training received and experience of the nursing staff, the number and duration of hemodialysis sessions per patient and CVC dysfunctions were obtained. The bacteremia’s that occurred in a year were counted, through the unit’s database, and the possible relationship of such variables in the rate of bacteremia was analyzed. Results: On a total of 41 tunneled catheters in 35 patients, observed for 365 days, an incidence rate of 1.45/1000 catheter days was obtained, not having found a statistically significant relationship with the training of nursing staff (p = 0.330), experience (p=0.668), number of dysfunctions and manipulations of catheter (p=0.718; p=0.118). An inverse relationship was observed with the number and duration of sessions (p=0.02). Conclusions: It is necessary to continue analyzing the relationship between the mentioned variables and the rate of bacteremia. Approaching it from a multicenter point of view or increasing the observation time prospectively may be aspects to consider to determine the variables that seem to have a direct relationship with CVC infection, which has been shown in other contexts.


REFERENCES

  1. Allon M. Dialysis catheter-related bacteremia: treatmentand prophylaxis. Am J Kidney Dis. 2004; [44:779]

  2. Beathard GA. Management of bacteremia associatedwith tunneled-cuffed hemodialysis catheters. J Am SocNephrol. 1999 ;10: [1045-9]

  3. Stevenson KB, Hannah EL, Lowder CA, AdcoxMJ, Davidson RL, Mallea MC, et al Epidemiologyof hemodialysis vascular access infection fromlongitudinal infection surveillance data: predicting theimpact of NKF-DOQI clinical practice guidelines forvascular access. Am J Kidney Dis. 2002 ;39: [549-55]

  4. Taylor G, Gravel D, Johnston L, Embil J, HoltonD, Paton S. Incidence of bloodstream infection inmulticenter infection cohorts of hemodialysis patients.Canadian Nosocomial Infection Surveillance Program,Canadian Hospital Epidemiology Committee. Am JInfect Control. 2004; [32:155]

  5. Weijmer MC, Vervloet MG, Ter Wee PM. Comparedto tunnelled cuffed haemodialysis catheters, temporaryuntunnelled catheters are associated with morecomplications already within 2 weeks of use. NephrolDial Transplant. 2004;19: [670- 7]

  6. Albalate M, Perez R, De Sequera P, Alcázar R, PuertaM, Ortega M, et al. ¿Hemos olvidado lo más importantepara prevenir las bacteriemias en pacientes portadoresde catéter para HD? Nefrología.2010;3: [573-7]

  7. Arribas P. Prevalencia de bacteriemias relacionadas conel catéter de hemodiálisis en una unidad hospitalaria.Enferm Nefrol.2013;16: [229-34]

  8. Mokrzycki MH, Zhang M, Cohen H, Golestaneh L,Laut JM, Rosenberg SO. Tunnelled haemodialysiscatheter bacteraemia: Risk factors for bacteraemiarecurrence, infectious complications and mortality.2006. Nephrol Dial Transplant. 2006;21: [1024–35]

  9. García P, Payá E, Olivares R, Cotera A, Rodríguez J,Sanz M. Diagnóstico de las infecciones asociadas acatéteres vasculares centrales. Rev Chil Infect. 2003; 20(1): [41- 50]

  10. Powe NR, Jaar B, Furth SL, Hermann J, Briggs W.Septicemia in dialysis patients: incidence, risk factors,and prognosis. Kidney Int.1999; 55: [1081- 90]

  11. Lok CE, Mokrzycki MH. Prevention and managementof catheter-related infection in hemodialysis patients.Kidney Int .2011; 79, [587– 98]

  12. Vijayan A, Boyce JM. 100% de uso de procedimientosde control de infecciones en instalaciones dehemodiálisis. CJASN.2018,13 (4) [671-3]

  13. Aguinada A, Del Pozo JL. Infección asociada a catéteren hemodiálisis: diagnóstico, tratamiento y prevención.NefroPlus. 2011; 4(2): [1-10]

  14. Silva T, De Marchi D, Mendes ML, Barretti P, PonceD. Approach to prophylactic measures for centralvenous catheter-related infections in hemodialysis: Acritical review. Hemodialysis International. 2014; 18:[15–23]

  15. D´Agata EMC, Mount DB, Thayer V, SchaffnerW. Hospital-acquired infections among chronichemodialisys patients. Am J Kidney Dis. 2000; 35(6):[1038-8]

  16. Miler LM, Clark E, Dipchand C, Hiremath S, KappelJ, Kiaii M et al. Hemodialysis Tunneled Catheter-Related Infections. Can J Kidney Health Dis. 2016;27;3

  17. Ferrer C, Almirante B. Infecciones relacionadas con eluso de los cateteres vasculares. Enferm Infecc MicrobiolClin. 2014; 32(2): [115-24]

  18. Zhang HH, Cortes-Penfield NW, Mandayam S,Niu J, Atmar RL, Wu E, et al. Dialysis CatheterrelatedBloodstream Infections in Patients ReceivingHemodialysis on an Emergency-only Basis: ARetrospective Cohort Analysis. Clin Infect Dis. 2019Mar;68(6): [1011-6]

  19. Soi V, Moore CL, Kumbar L, Yee J. Prevention ofcatheter-related bloodstream infections in patients onhemodialysis: challenges and management strategies.Int J Nephrol Renovasc Dis. 2016; 9: [95-103]

  20. Ibeas J, Roca-Tey R, Vallespín J, Moreno T, MoñuxG, Martí-Monrós A, et al. Guía Clínica Española delAcceso Vascular para Hemodiálisis. Nefrología. 2017;37(November): [1-193]

  21. Crespo María, Ruiz MC, Gómez M, Crespo R. Lasbacteriemias relacionadas con el catéter tunelizado dehemodiálisis y cuidados de enfermería. Enferm Nefrol.2017; 20(4): [353-65]

  22. Concepción D, Felizardo G, Moran J, Peters V, ShapiroS, Yu M. Guide to the Elimination of Infections inHemodialysis. Infection Control. 2009. [1-58]

  23. Centros para el C o n t r o ly la Prevención de Enfermedades.CoreIntervenciones. [Internet]. Georgia: Departamentode Salud y Servicios Humanos de los Estados Unidos.15de Junio de 2016. [Consultado 18 de Octubre2020]. Disponible en: https://www.cdc.gov/dialysis/prevention-tools/core- interventions.html

  24. Schweiger A, Trevino S, Marschall J. Nosocomialinfections in dialysis access. Contrib Nephrol. 2015;184:[205-21]

  25. NFK/DOQI. Clinical Practice Guidelines for VascularAccess. Am J Kidney Dis. 2006;48 (Suppl 1): [176-273]

  26. Crehuet I, Bernárdez MA. Aplicación de protocolosen enfermería: la mejor barrera contra las infecciones delos catéteres de hemodiálisis. Enferm Nefrol .2018 Sep;21( 3 ): 263-268.

  27. Beathard GA, Urbanes A. Infection associatedwith tunneled hemodialysis catheters. Semin Dial.2008;21(6): [528-38]

  28. Besarab A, Pandey R. Catheter management inhemodialysis patients: delivering adequate flow. Clin JAm Soc Nephrol. 2011;6: [227-34]

  29. Onder AM, Chandar J, Coakley S, FrancoeurD, Abitbol C, Zilleruelo G. Controll ing exit siteinfections: does it decrease the incidence of catheterrelated bacteriemia in children on chronic hemodialysis.Hemodial int. 2009; 13: [11-8]

  30. Akoh JA. Vascular Access Infections: Epidemiology,Diagnosis, and Management. Curr Infect Dis Rep. 2011;13: [324-32]

  31. Cobo JL, Sainz RA, Vicente MY, Cepa H, Pelayo R,Menezo R, et al. Estudio comparativo de incidencia debacteriemias relacionadas con el catéter de hemodiálisis:bioconectores frente a conexión directa. Rev Soc EspNnferm Nefrol. 2011;14(4):[23].




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Rev Nefrol Dial Traspl. 2022;42