Abstract

HEMODIALYSIS CATHETER - ASSOCIATED BLOODSTREAM INFECTIONS: A COMBINED RETROSPECTIVE AND PROSPECTIVE STUDY

*Sr. Binu Jose, Aalia Ps, Dona Daison, Elizabeth K. Thomas, Jeethu Jose and
Dr. Binu Upendran

ABSTRACT

Background: Catheter-related bloodstream infection (CRBSI) is asignificant complication in hemodialysis patients. This study aimedto identify causative pathogens, associated risk factors, antibioticsensitivity patterns, and management strategies in CRBSI cases.Materials and Methods: A retroprospective analysis was conductedat a tertiary care hospital from 2018 to 2023. Demographic andclinical data of patients with CRBSI were collected and analyzed.Results: A total of 73 patients were studied, with a higherprevalence in males (69.9%) and the 61–70 age group (35.6%).Common symptoms included fever (79.4%), breathlessness(23.2%), and chills (20.5%). Elevated WBC counts were observedin 68.5%, with universally raised ESR, CRP, and neutrophil levels.Diabetics (n=46) had a higher CRBSI rate than non-diabetics. Mostcatheters were internal jugular and permanent, with infectionsfrequently occurring within 1–6 months of insertion (34.2%). E. coli (47.8%) was thepredominant gram-negative pathogen, and Staphylococcus aureus (46%) was the leadinggram-positive organism. Empirical treatment most often included vancomycin plusamikacin (36.9%), while, cefoperazone-sulbactam 1.5 g was the most common definitivetherapy for both gram- positive (34%) and gram-negative (39.1%) infections.Conclusion: CRBSI was more commonly caused by gram-positive bacteria. Earlydiagnosis, appropriate empirical therapy, and awareness of antibiotic resistance patterns are key to effective management.

Keywords: Catheter-related bloodstream infection (CRBSI), Risk factors, Antibiotic sensitivity, Empirical therapy, Definitive therapy.