Empirical and culture-based antibiotic therapy used in managing catheter related blood stream infection in people undergoing hemodialysis in northern Tanzania: a retrospective cohort study.

 

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Empirical and culture-based antibiotic therapy used in managing catheter related blood stream infection in people undergoing hemodialysis in northern Tanzania: a retrospective cohort study.

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Regional data on the bacterial profile and antibiotic susceptibility pattern remain limited in Tanzania. This study aimed to determine the bacterial spectrum, antibiotic susceptibility patterns, and clinical determinants of catheter related blood stream infectionI among hemodialysis patients in Northern Tanzania.

A retrospective cohort study was conducted at the Kilimanjaro Christian Medical Centre (KCMC). The study included adults with end-stage kidney disease (ESKD) on maintenance hemodialysis and acute kidney injury (AKI) patients who required dialysis based on standard indications between January 2021 and December 2022. Data were retrieved from the hospital electronic medical records. Bacterial identification and antibiotic susceptibility testing were performed according to the Clinical and Laboratory Standards Institute (CLSI, 2022). Statistical analysis was performed using SPSS version 27. Associations between patient factors and CRBSI were analyzed using the Cox proportional hazards model, and a p-value < 0.05 was considered statistically significant.

Gram-positive bacteria were the most frequently isolated pathogens (69.7%), followed by gram-negative organisms (14.3%). Vancomycin demonstrated the highest sensitivity among gram-positive isolates (99%), whereas meropenem showed the best activity against gram-negative isolates (82.1%). Reduced susceptibility was observed for ciprofloxacin, ceftriaxone, and trimethoprim–sulfamethoxazole. Clinical factors associated with infection included hypoalbuminemia (<35 g/L), anemia (Hb <10 g/dL), diabetes mellitus, and femoral catheterization. Refer to table02.

Catheter related blood stream infection among hemodialysis patients in Northern Tanzania is mainly caused by gram-positive bacteria that remain highly sensitive to vancomycin. Continuous local surveillance of antibiotic susceptibility is essential to guide emp
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