Incidence and challenges in management of hemodialysis catheter-related infections
Abstract Catheter-related infections (CRI) are a major cause of morbidity and mortality in chronic hemodialysis (HD) patients. In this paper, we share our experience with CRI in HD patients. We recorded 49 cases of CRI among 167 patients during a period of 40 months (January 2018–April 2021). The in...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2022-11-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-23787-5 |
| _version_ | 1811315068507258880 |
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| author | Meriam Hajji Manel Neji Sahar Agrebi Saoussen Ben Nessira Fethi Ben Hamida Samia Barbouch Amel Harzallah Ezzedine Abderrahim |
| author_facet | Meriam Hajji Manel Neji Sahar Agrebi Saoussen Ben Nessira Fethi Ben Hamida Samia Barbouch Amel Harzallah Ezzedine Abderrahim |
| author_sort | Meriam Hajji |
| collection | DOAJ |
| description | Abstract Catheter-related infections (CRI) are a major cause of morbidity and mortality in chronic hemodialysis (HD) patients. In this paper, we share our experience with CRI in HD patients. We recorded 49 cases of CRI among 167 patients during a period of 40 months (January 2018–April 2021). The incidence of CRI was 3.7 per 1000 catheter-days. The revealing symptoms were dominated by fever or chills (90%). Inflammatory signs were observed in 74% of cases with respectively concurrent exit-site (51%) and tunnel infection (6%). The biological inflammatory syndrome was found in 74% of patients (average CRP level = 198.9 mg/l). Blood cultures were performed in all cases and were positive in 65% of cases. Thirteen patients have been diagnosed with Infection complications, which were respectively infective endocarditis in 7 cases, septic arthritis in 3 cases, infective myositis in one case, cerebral thrombophlebitis in 1 case and mediastinitis in 1 case. The death occurred in eleven patients, it was due to septic shock in 9 cases, pulmonary embolism in one case and neurologic alterations related to cerebral thrombophlebitis. The mean seniority in HD was 16.5 months in the group with CRI and 3.7 months in the group without CRI (p < 0.04). We did not notice significant difference in mortality between tunnelled and non-tunnelled catheters. CRI does not seem to be more severe in patients with diabetes. Duration of use of the HD catheter (p < 0.007) and ferritin level (p < 0.0001) were independent factors that predispose to CRI in our population. |
| first_indexed | 2024-04-13T11:23:41Z |
| format | Article |
| id | doaj.art-d4d8499ccbbf48539afbb50a5ce38468 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-13T11:23:41Z |
| publishDate | 2022-11-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-d4d8499ccbbf48539afbb50a5ce384682022-12-22T02:48:45ZengNature PortfolioScientific Reports2045-23222022-11-0112111010.1038/s41598-022-23787-5Incidence and challenges in management of hemodialysis catheter-related infectionsMeriam Hajji0Manel Neji1Sahar Agrebi2Saoussen Ben Nessira3Fethi Ben Hamida4Samia Barbouch5Amel Harzallah6Ezzedine Abderrahim7Department of Internal Medicine “A”, Charles Nicolle HospitalDepartment of Internal Medicine “A”, Charles Nicolle HospitalDepartment of Internal Medicine “A”, Charles Nicolle HospitalDepartment of Internal Medicine “A”, Charles Nicolle HospitalDepartment of Internal Medicine “A”, Charles Nicolle HospitalDepartment of Internal Medicine “A”, Charles Nicolle HospitalDepartment of Internal Medicine “A”, Charles Nicolle HospitalDepartment of Internal Medicine “A”, Charles Nicolle HospitalAbstract Catheter-related infections (CRI) are a major cause of morbidity and mortality in chronic hemodialysis (HD) patients. In this paper, we share our experience with CRI in HD patients. We recorded 49 cases of CRI among 167 patients during a period of 40 months (January 2018–April 2021). The incidence of CRI was 3.7 per 1000 catheter-days. The revealing symptoms were dominated by fever or chills (90%). Inflammatory signs were observed in 74% of cases with respectively concurrent exit-site (51%) and tunnel infection (6%). The biological inflammatory syndrome was found in 74% of patients (average CRP level = 198.9 mg/l). Blood cultures were performed in all cases and were positive in 65% of cases. Thirteen patients have been diagnosed with Infection complications, which were respectively infective endocarditis in 7 cases, septic arthritis in 3 cases, infective myositis in one case, cerebral thrombophlebitis in 1 case and mediastinitis in 1 case. The death occurred in eleven patients, it was due to septic shock in 9 cases, pulmonary embolism in one case and neurologic alterations related to cerebral thrombophlebitis. The mean seniority in HD was 16.5 months in the group with CRI and 3.7 months in the group without CRI (p < 0.04). We did not notice significant difference in mortality between tunnelled and non-tunnelled catheters. CRI does not seem to be more severe in patients with diabetes. Duration of use of the HD catheter (p < 0.007) and ferritin level (p < 0.0001) were independent factors that predispose to CRI in our population.https://doi.org/10.1038/s41598-022-23787-5 |
| spellingShingle | Meriam Hajji Manel Neji Sahar Agrebi Saoussen Ben Nessira Fethi Ben Hamida Samia Barbouch Amel Harzallah Ezzedine Abderrahim Incidence and challenges in management of hemodialysis catheter-related infections Scientific Reports |
| title | Incidence and challenges in management of hemodialysis catheter-related infections |
| title_full | Incidence and challenges in management of hemodialysis catheter-related infections |
| title_fullStr | Incidence and challenges in management of hemodialysis catheter-related infections |
| title_full_unstemmed | Incidence and challenges in management of hemodialysis catheter-related infections |
| title_short | Incidence and challenges in management of hemodialysis catheter-related infections |
| title_sort | incidence and challenges in management of hemodialysis catheter related infections |
| url | https://doi.org/10.1038/s41598-022-23787-5 |
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