Abstract: 【Abstract】Objective To investigate microbiological and clinical characteristics of tunnelled and cuffed hemodialysis catheter- related bloodstream infections (CRBSIs). Methods The medical records of all patients with confirmed CRBSIs diagnosed in Peking University First Hospital from August 2008 to August 2018 were retrospectively reviewed, and 55 cases with CRBSIs were enrolled. Clinical and microbiological data were collected and analyzed. Results Fever, exit-site infection, tunnel infection and catheter dysfunction were observed in 100%, 21.8%, 7.3% and 20.0% respectively of the cases. The positive rates of blood cultures from peripheral blood (100% vs. 81.5% , P=0.047) and blood within catheters (93.3% vs. 81.5% , P=0.028) before antimicrobial therapy were significantly higher than those after antimicrobial therapy. There were 77 positive cultures that yielded 45.5% Gram-positive, 53.2% Gram-negative and 1.3% fungal isolates. The most common organism isolated was methicillin-resistant staphylococcus aureus (MRSA,19.5%). Conclusion Standardized collection of specimens is essential for the diagnosis of CRBSIs. Gram-negative isolates accounted for most tunnelled CRBSIs in our center. For patients with suspected CRBSIs, the empirical antibiotic regimen should include agents actively against both MRSA and Gram-negative bacteria.

Key words: Hemodialysis, Infection, Tunnelled catheter