Catheter associated infections in immunocompromised patients on chronic hemodialysis
Assist. Prof. Svetla Vassileva Staykova , A. Stoyanov, K. Nenov
Clinic of Dialysis, University hospital Sv. Marina, Medical University – Varna
Common complications of permanent catheters (PCs) are thrombosis and the emergence of so-called catheter-associated infections (CAI).
Tunneled dialysis catheters are often used for temporary vascular access in hemodialysis patients, but are complicated by systemic infections.
Purpose of the study is to analyze and diagnose complications of vascular access, and the conduct of clinical screening of patients with CKD on the selection of operational or procedural plan.
Material and methods
42 of 162 dialysis patients in the dialysis clinic of University Hospital “St. Marina” – Varna had as a vascular access tunneled permanent catheters. The age of the patients was 35-80. These 42 hemodialysis patients were monitored for infection during a 12-month period. Data recorded for each patient included the number of catheter-days, episodes of suspected bacteremia, blood culture results, method of treatment, complications and outcomes.
Results and discussion
The treatment of bacteremia associated with infected tunneled catheters requires venous antibiotic therapy and often a catheter replacement. Infected catheters were removed followed by delayed catheter replacement 3 to 10 days later. All patients were treated with a 14 – 21-day course of intravenous antibiotics based on culture sensitivities. Patients respond well to antibiotic treatment, all symptoms resolved, control blood cultures were sterile.
Clinical catheter-associated infections can be detected by skin yeast secretion catheter site entrance and the classic signs of local inflammation – swelling, redness, pain, warmth.
Creating and maintaining effective and functioning vascular access, together with the successful management of common complications arising therefrom, establish a growing collaboration of medical professionals involved in morbidity, hospitalization and treatment of patients with CKD. By improving extracorporeal methods of treatment for patients with terminal chronic renal failure not only increases the duration of their lives, but enabling them to lead a full existence.