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Risk factors for bloodstream infection in patients at a Brazilian hemodialysis center: a case–control study

BACKGROUND: Infection is the leading cause of morbidity and the second leading cause of mortality in patients on renal replacement therapy. The rates of bloodstream infection in hemodialysis patients vary according to the type of venous access used. Gram-positive bacteria are most frequently isolate...

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Autores principales: Fram, Dayana, Okuno, Meiry Fernanda Pinto, Taminato, Mônica, Ponzio, Vinicius, Manfredi, Silvia Regina, Grothe, Cibele, Belasco, Angélica, Sesso, Ricardo, Barbosa, Dulce
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4377039/
https://www.ncbi.nlm.nih.gov/pubmed/25879516
http://dx.doi.org/10.1186/s12879-015-0907-y
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author Fram, Dayana
Okuno, Meiry Fernanda Pinto
Taminato, Mônica
Ponzio, Vinicius
Manfredi, Silvia Regina
Grothe, Cibele
Belasco, Angélica
Sesso, Ricardo
Barbosa, Dulce
author_facet Fram, Dayana
Okuno, Meiry Fernanda Pinto
Taminato, Mônica
Ponzio, Vinicius
Manfredi, Silvia Regina
Grothe, Cibele
Belasco, Angélica
Sesso, Ricardo
Barbosa, Dulce
author_sort Fram, Dayana
collection PubMed
description BACKGROUND: Infection is the leading cause of morbidity and the second leading cause of mortality in patients on renal replacement therapy. The rates of bloodstream infection in hemodialysis patients vary according to the type of venous access used. Gram-positive bacteria are most frequently isolated in blood cultures of hemodialysis patients. This study evaluated risk factors for the development of bloodstream infections in patients undergoing hemodialysis. METHODS: Risk factors associated with bloodstream infections in patients on hemodialysis were investigated using a case–control study conducted between January 2010 and June 2013. Chronic renal disease patients on hemodialysis who presented with positive blood cultures during the study were considered as cases. Controls were hemodialysis patients from the same institution who did not present with positive blood cultures during the study period. Data were collected from medical records. Logistic regression was used for statistical analysis. RESULTS: There were 162 patients included in the study (81 cases and 81 controls). Gram-positive bacteria were isolated with the highest frequency (72%). In initial logistic regression analysis, variables were hypertension, peritoneal dialysis with previous treatment, type and time of current venous access, type of previous venous access, previous use of antimicrobials, and previous hospitalization related to bloodstream infections. Multiple regression analysis showed that the patients who had a central venous catheter had an 11.2-fold (CI 95%: 5.17–24.29) increased chance of developing bloodstream infections compared with patients who had an arteriovenous fistula for vascular access. Previous hospitalization increased the chance of developing bloodstream infections 6.6-fold (CI 95%: 1.9–23.09). CONCLUSIONS: Infection prevention measures for bloodstream infections related to central venous catheter use should be intensified, as well as judicious use of this route for vascular access for hemodialysis. Reducing exposure to the hospital environment through admission could contribute to a reduction in bloodstream infections in this population.
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spelling pubmed-43770392015-03-29 Risk factors for bloodstream infection in patients at a Brazilian hemodialysis center: a case–control study Fram, Dayana Okuno, Meiry Fernanda Pinto Taminato, Mônica Ponzio, Vinicius Manfredi, Silvia Regina Grothe, Cibele Belasco, Angélica Sesso, Ricardo Barbosa, Dulce BMC Infect Dis Research Article BACKGROUND: Infection is the leading cause of morbidity and the second leading cause of mortality in patients on renal replacement therapy. The rates of bloodstream infection in hemodialysis patients vary according to the type of venous access used. Gram-positive bacteria are most frequently isolated in blood cultures of hemodialysis patients. This study evaluated risk factors for the development of bloodstream infections in patients undergoing hemodialysis. METHODS: Risk factors associated with bloodstream infections in patients on hemodialysis were investigated using a case–control study conducted between January 2010 and June 2013. Chronic renal disease patients on hemodialysis who presented with positive blood cultures during the study were considered as cases. Controls were hemodialysis patients from the same institution who did not present with positive blood cultures during the study period. Data were collected from medical records. Logistic regression was used for statistical analysis. RESULTS: There were 162 patients included in the study (81 cases and 81 controls). Gram-positive bacteria were isolated with the highest frequency (72%). In initial logistic regression analysis, variables were hypertension, peritoneal dialysis with previous treatment, type and time of current venous access, type of previous venous access, previous use of antimicrobials, and previous hospitalization related to bloodstream infections. Multiple regression analysis showed that the patients who had a central venous catheter had an 11.2-fold (CI 95%: 5.17–24.29) increased chance of developing bloodstream infections compared with patients who had an arteriovenous fistula for vascular access. Previous hospitalization increased the chance of developing bloodstream infections 6.6-fold (CI 95%: 1.9–23.09). CONCLUSIONS: Infection prevention measures for bloodstream infections related to central venous catheter use should be intensified, as well as judicious use of this route for vascular access for hemodialysis. Reducing exposure to the hospital environment through admission could contribute to a reduction in bloodstream infections in this population. BioMed Central 2015-03-26 /pmc/articles/PMC4377039/ /pubmed/25879516 http://dx.doi.org/10.1186/s12879-015-0907-y Text en © Fram et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Fram, Dayana
Okuno, Meiry Fernanda Pinto
Taminato, Mônica
Ponzio, Vinicius
Manfredi, Silvia Regina
Grothe, Cibele
Belasco, Angélica
Sesso, Ricardo
Barbosa, Dulce
Risk factors for bloodstream infection in patients at a Brazilian hemodialysis center: a case–control study
title Risk factors for bloodstream infection in patients at a Brazilian hemodialysis center: a case–control study
title_full Risk factors for bloodstream infection in patients at a Brazilian hemodialysis center: a case–control study
title_fullStr Risk factors for bloodstream infection in patients at a Brazilian hemodialysis center: a case–control study
title_full_unstemmed Risk factors for bloodstream infection in patients at a Brazilian hemodialysis center: a case–control study
title_short Risk factors for bloodstream infection in patients at a Brazilian hemodialysis center: a case–control study
title_sort risk factors for bloodstream infection in patients at a brazilian hemodialysis center: a case–control study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4377039/
https://www.ncbi.nlm.nih.gov/pubmed/25879516
http://dx.doi.org/10.1186/s12879-015-0907-y
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