Chinese Journal of Blood Purification ›› 2024, Vol. 23 ›› Issue (12): 943-946.doi: 10.3969/j.issn.1671-4091.2024.12.013

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Analysis of catheter-related bloodstream infections on seasonal prevalence, pathogen characteristics, and drug sensitivity in maintenance hemodialysis patients

ZHANG Yan, GAO Zhi-wei, LIAN Xiu-hua, WANG Zun-song   

  1. Hemodialysis Division and 2Department of Nephrology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan 250014, China
  • Received:2024-04-07 Revised:2024-09-18 Online:2024-12-12 Published:2024-12-12
  • Contact: 250014 济南,山东第一医科大学第一附属医院(山东省千佛山医院) 2肾病学科,山东省肾病研究所 E-mail:wzsong3@163.com

Abstract: Objective  To analyze the seasonal prevalence, pathogen characteristics, and drug sensitivity of catheter-related blood stream infection (CRBSI) in maintenance hemodialysis (MHD) patients.  Method  A retrospective analysis was conducted on the patients treated with tunnel-cuffed catheter (TCC) insertion surgery for MHD at the Department of Nephrology, The First Affiliated Hospital of Shandong First Medical University from August 2012 to June 2021. CRBSI happened in a total of 62 hospitalized patients, including 48 patients with defined pathogenic bacteria from blood cultures. Their infection season, pathogenic bacterial characteristics and drug sensitivity were analyzed.  Results  CRBSI occurred higher in spring and summer (38 cases, 61.3%) than in autumn and winter (24 cases, 38.7%) (c2=6.323, P=0.012). Gram positive bacteria accounted for 52.9%, and Gram negative bacteria for 45.1%. More than half of the Gram positive bacteria were staphylococcus aureus (63.0%), followed by staphylococcus epidermidis (22.2%). Many types of Gram negative bacteria caused the CRBSI, and Escherichia coli accounted for 21.7% of Gram negative bacteria. Antibiotics sensitive to Gram positive bacteria included vancomycin, teicoplanin, tigecycline, antibiotics with higher resistance rates included penicillin G, erythromycin, and clindamycin. Antibiotics sensitive to gram-negative bacteria included ertapenem, piperacillin/tazobactam, cefoperazone/sulbactam, antibiotics with higher resistance rates included ampicillin and cefazolin.  Conclusion  The incidence of CRBSI is higher in spring and summer. Staphylococcus aureus and staphylococcus epidermidis account for the vast majority of Gram positive bacteria. Many types of Gram negative bacteria are involved in CRBSI, with Escherichia coli being the most common bacterium. When the use of special grade antibiotics is restricted, moxifloxacin combined with piperacillin/tazobactam or cefoperazone/sulbactam can be considered as an empirical antibiotic treatment option for CRBSI.

Key words: Hemodialysis, Catheter related blood stream infection, Pathogenic bacteria, Drug sensitivity analysis

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