STUDY OF CENTRAL VENOUS CATHETER RELATED BLOOD STREAM INFECTIONS IN PATIENTS ON HAEMODIALYSIS
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2018, Vol 5, Issue 4
Abstract
BACKGROUND Temporary and permanent central venous catheters are used in majority of patients of CKD when initiated on hemodialysis and mostly these catheters act as bridge before permanent AV fistula assess could be obtained. Blood stream infections related to these central venous catheters are an important cause of morbidity and mortality in these patients. Appropriate antiseptic precautions while inserting central venous catheter and early identification of catheter related blood stream infections (CRBSI) are of utmost importance for reducing hospital stay, cost of therapy and mortality. MATERIALS AND METHODS A total of 50 patients of CKD were included in the study who had central venous catheter in situ (internal jugular or subclavian) and developed symptoms related to blood stream infections. Blood cultures were obtained from the catheter lumen and a separate venous site 1 hour apart. All the culture sensitivity reports were obtained from department of microbiology of our institute. Inclusion Criteria- Known case of CKD patients aged more than 18yrs on hemodialysis with symptoms and signs of catheter related blood stream infections were included in the study. Exclusion Criteria- Patients with other associated comorbid infections like Koch’s, urinary tract infection or others mimicking symptoms of CRBSI. RESULTS The cultures were found positive in 38 patients (76%) while in rest 24% cases positive cultures could not be obtained. Out of culture positive patients 52.63% cases were found to have gram positive infections while 44.74% had gram negative infections. In 2.63% patients, fungus was isolated to be the causative organism. Among the gram positive organisms 50% had CoNS, 30% had MSSA and 20% had MRSA infections. Among the gram negative group, 47.06% had klebsiella, 23.53% had acinetobacter, 17.65% had E.coli and 11.76% had pseudomonas as the causative organisms. Mortality was observed in 14% patients out of which 28.57% were culture negative and the rest culture positive. No mortality was observed in patients with gram positive cultures and E.Coli infections. Mortality in culture positive group was predominantly in klebsiella (40%), Acinetobacter (40%) and pseudomonas (20%) CONCLUSION CRBSI related bacteremia and sepsis pose a major cause of morbidity and mortality among CKD patients and also increase the cost of therapy and financial burden of healthcare. Simple handwashing techniques, proper handling of CVCs during dialysis, antiseptic and antibiotic locking of catheters remain gold standard to reduce CRBSIs. CRBSIs are certainly not inevitable completely but preventable to a significant extent
Authors and Affiliations
Pranjal Pankaj, Dilip Kumar Sinha, Medha Das, Shweta Tripathi, Shalu Purwar
Keywords
Related Articles
- EP ID EP450983
- DOI 10.18410/jebmh/2018/70
- Views 81
- Downloads 0
OVARIAN DERMOID WITH A MESENTERIC CYST- AN UNUSUAL CO-OCCURRENCE
PRESENTATION OF CASE A 30 year old female patient presented with chronic dullaching abdominal pain since the past 3 years. There was no specific localization of pain. There was no fever or any significant medical history...
PREVALENCE OF THYROID DYSFUNCTION AMONG FIRST YEAR MEDICAL STUDENTS IN A TERTIARY CARE TEACHING HOSPITAL
BACKGROUND Thyroid dysfunction is very common in India. Among the thyroid disorders, it has been found that there is an increase in prevalence of Subclinical Hypothyroidism rather than Hypothyroidism in India. Although i...
TRENDS IN SEROPREVALENCE OF TRANSFUSION TRANSMISSIBLE INFECTIONS AMONGST THE BLOOD DONORS IN TERTIARY CARE CENTRE
BACKGROUND Blood transfusion carries the potential risk of transfusion transmissible infections (TTIs) making it the most dreaded complication of blood transfusion. The objective was to study the trends in seroprevalence...
A RARE CASE OF ACHONDROPLASIA- SHORT LIMB
BACKGROUND A 6-year-old boy was presented to the paediatric department with shortening of all the limbs and delay in growth. Clinical examinations revealed height less than third percentile along with other abnormalities...
A PROSPECTIVE OBSERVATIONAL STUDY ON POISONING CASES IN A TERTIARY CARE HOSPITAL IN TAMILNADU
BACKGROUND High incidence of encounters with agricultural poisons, and lack of data from Indian scenario, necessitate studies in this regard. Our study aims at investigating the pattern of acute poisoning cases in a tert...