Introduction:
Blood stream infections can lead to significant morbidity in patients undergoing hemodialysis. The causative agents responsible for blood stream infection vary depending on local biogram. It is important to study the incidence of Blood stream infection in dialysis center and implement the infection prevention policies according to the spectrum of organism found responsible.
Methods:
It is a retrospective cohort study of blood stream infection in a tertiary care hemodialysis center in Mumbai with 40 dialysis beds from January 2020 to June 2024. Patients with blood culture positive blood stream infection were recruited to know the incidence of catheter related blood stream infections and spectrum of organisms involved. Whenever feasible peripheral blood was obtained for culture along with blood from central catheter in cases of catheter related blood stream infections. The incidence of catheter related blood stream infections is expressed as per 1000 catheter days.
Results:
There were 53 patients who had BSI in 4.5 years out of which 48 patients had CRBSI. 5 Patients (9%) had AV fistula, 9 patients (17%) had HD catheters, 39 patients (74%) had tunneled central catheters. 28 patients (56%) had gram negative bacterial infection, 23 (44%) patients had gram positive bacterial infection and 3 patients had candida infection. The incidence of CRBSI was 0.55 in 2020, 0.27 in 2021, 0.70 in 2022, 0.51 in 2023 and 0.25 from January 20204 till June 2024. There were 28% dialysis patients with catheters in 2020 which increased to 42% in 2024. Most common organism isolated was Methicillin-sensitive staphylococcus aureus (MSSA) responsible for 18% of BSI followed by klebsiella pneumonia responsible for 13% of BSI and candida species were responsible for 5% of BSI.
Conclusions:
Increasing number of dialysis catheters might be responsible for rise in number of CRBSI. This study let us compare the incidence of blood stream infections in our center to global standards. This study will help us know the spectrum of organisms and choice of empirical antibiotics to be used.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.