Evaluation of Central Venous Catheter for Dialysis Associated with Bloodstream Infections.

Objective : Hemodialysis (HD) catheter-related bloodstream infections (CRBSIs) are a major complication of long-/short-term catheter. Material and Methods : Patients with HD CRBSIs were identified, and their blood was taken and sent to clinical pathology for culture and sensitivity testing. The inclusion criteria were adults with end-stage renal disease who required urgent HD access in the presence of a central venous catheter (CVC) infection. Results : The most common isolates among the patients with CRBSIs were gram-positive microorganisms (57.5%) and gram-negative organisms (42.5%). Overall, in our entire study, Staphylococcus aureus was the most common pathogen isolated, accounting for 30%, followed by Pseudomonas aeruginosa (20%), coagulase-negative staphylococci (CoNS) (12.5%), Klebsiella spp. and Acinetobacter (10%), Staphylococcus epidermidis (7.5%), and methicillin-resistant Staphylococcus aureus (MRSA), Escherichia coli , Staphylococcus hominis , and Enterococcus faecalis (2.5%). The commonest bacterial in femoral was S. aureus , and for subclavian was Pseudomonas aeruginosa . All S. aureus were sensitive to aminoglycosides and quinolones. P. aeruginosa was sensitive to the third generation of cephalosporins, especially cefoperazone and carbapenem. Conclusion: Nontunneled CVCs used for more than 2 weeks could increase the risk of CRBSIs. Procalcitonin and erythrocyte sedimentation rate could predict the CRBSIs in this study. This study also revealed that the gram-positive bacteria were primadonna in dialysis of CRBSIs, and most of them were sensitive to aminoglycosides.