PREVALENCE AND MICROBIOLOGIC PROFILE OF CATHETER-RELATED BLOODSTREAM INFECTIONS IN CHRONIC KIDNEY DISEASE PATIENTS IN BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER

 

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https://storage.unitedwebnetwork.com/files/1099/621d31a1553d6efb36453a946fd40644.pdf
PREVALENCE AND MICROBIOLOGIC PROFILE OF CATHETER-RELATED BLOODSTREAM INFECTIONS IN CHRONIC KIDNEY DISEASE PATIENTS IN BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER

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CINDERELLA
GERNA
CINDERELLA GERNA cinderellam.gerna@gmail.com Baguio General Hospital and Medical Center Internal Medicine BAGUIO CITY Philippines *
VIRGINIA BARRY-MANGATI virginiabarry.mangati@gmail.com Baguio General Hospital and Medical Center BGHMC Section of Adult Nephrology BAGUIO CITY Philippines -
BERNARD DEMOT demotbernard@gmail.com Baguio General Hospital and Medical Center BALAI HIV-AIDS CORE TEAM (HACT) Baguio City Philippines -
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INTRODUCTION: Central venous catheters (CVCs) are utilized as access for hemodialysis (HD) in emergency settings in Baguio General Hospital and Medical Center (BGHMC). CVCs remain the primary vascular access for chronic kidney disease (CKD) patients undergoing hemodialysis until there is available chronic HD access. Among nosocomial infections, 10-15% are intravascular device-related bacteremia, in which CVCs account for most of these infections, with an estimated mortality rate of 12-25% (9). There is a discernible scarcity of local publications explicitly addressing catheter-related bloodstream infections (CRBSI) in hemodialysis patients (15).

METHODS: Cross-sectional study and random sampling were performed by reviewing medical charts, hemodialysis unit data, and microbiological laboratory records. The study population included adult patients diagnosed with CKD requiring HD, who had been inserted with CVC and underwent hemodialysis in BGHMC. A sample size of at least 329 subjects was needed to achieve 95% significance level using OpenEpi and was modified based on an expected occurrence rate of 31% for CRBSI in hemodialysis patients (15).

RESULTS: Prevalence of CRBSI was documented at 12.67 episodes per 1000 CVC days with median duration of CVC at 58 days. Pseudomonas aeruginosa (n = 6, 15%) was the most common causative organism for gram negative and Staphylococcus aureus (n = 5, 12.5%) for gram positive isolates.

CONCLUSION: The noted increased prevalence of CRBSI could be attributed to prolonged catheter days. The increasing prevalence calls for re-evaluation of practices involving CVC and strict adherence to recommendation that CVC should be switched as soon as possible from CVC to arteriovenous fistula (AVF) or arteriovenous graft (AVG).

Kewords