Catheter Use in Dialysis Linked to Bloodstream Infection Risk

Central venous catheter use during hemodialysis is linked to increased rates of bloodstream infection, according to a report from the CDC.

The review included data from 6005 outpatient hemodialysis facilities submitted in 2014 to National Healthcare Safety Network Dialysis Event Surveillance. The facilities reported 160,971 dialysis events and 29,516 bloodstream infections, 149,722 intravenous antimicrobial starts, and 38,310 pus, redness, or increased swelling at the hemodialysis vascular access site events.
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Overall, 76.5% of the bloodstream infections were vascular access related, 69.8% of which occurred in patients with a central venous catheter. The rate of bloodstream infections per 100 patient-months was 0.26 for arteriovenous fistula, 0.39 for arteriovenous graft, and 2.16 for central venous catheter. Other dialysis event rates were also highest among patients with a central venous catheter, and Staphylococcus aureus was the most common bloodstream infection pathogen, 39.5% of which were resistant to methicillin.

“Although a minority of patients seemed to have dialyzed with a central venous catheter, the infection rates and burden were higher among this group than patients with other vascular access types. Although important opportunities exist for data quality improvement, we believe that the data are nationally representative. Local and regional efforts to reduce infections among this vulnerable patient population should incorporate this established system of measurement,” the researchers concluded.

—Michael Potts

Reference:

Nguyen DB, Shugart A, Lines C, et al. National Healthcare Safety Network (NHSN) Dialysis Event Surveillance Report for 2014 [published online June 2017]. CJASN. doi: 10.2215/​CJN.11411116.