Keywords
Catheter-related infections
Hemodialysis
Case-control studies
How to Cite
Abstract
Background: Bacteremia in patients on chronic hemodialysis using a central venous catheter represents a high morbidity and mortality in patients with chronic kidney disease.
Purpose: Identify the associated factors such as sociodemographic characteristics, comorbidities, and clinical characteristics of bacteremia in hemodialysis and identify the main microorganisms in the Ramiro Priale Priale Hospital, Huancayo from January 2020 - March 2023.
Methodology: An observational, retrospective case-control study of 60 patients was carried out. 25 cases and 35 controls were acquired.
Results: 60 patients were studied. The population was mainly male with 58.3% (n=56) cases. Most of the patients came from Huancayo 31% (n=19). 93.3% of the patients presented arterial hypertension (AHT), and 38.3% had type 2 diabetes mellitus (DM2). Among the comorbidities, the most frequent was heart disease with 30% (n=18) of the cases. The main germs found were Staphylococcus Aureus (24%) and Staphylococcus epidermidis (24%). A significant association was found between the presence of type 2 diabetes mellitus (OR=5.65) (95% CI 1.23-10.98) and the presence of comorbidity (OR=13.026) (95% CI 2.2-15.4) with the presence of bacteremia (p <0.05).
Conclusions: Diabetes mellitus and the presence of comorbidities are associated with the presence of bacteremia in patients on chronic hemodialysis.
References
Lv JC, Zhang LX. Prevalence and disease burden of chronic kidney disease. Adv Exp Med Biol. 2019;1165:3-15. https://doi.org/10.1007/978-981-13-8871-2_1
Herrera-Añazco P, Taype-Rondan A, Lazo-Porras M, Quintanilla EA, Ortiz-Soriano VM, Hernandez AV. Prevalence of chronic kidney disease in Peruvian primary care setting. BMC Nephrol. 2017;18(1):246. https://doi.org/10.1186/s12882-017-0655-x
Thurlow J, Joshi M, Yan G, Norris KC, Agodoa LY, Yuan CM, et al. Global epidemiology of end-stage kidney disease and disparities in kidney replacement therapy. Am J Nephrol. 2021;52(2):98-107. https://doi.org/10.1159%2F000514550
Bravo-Zúñiga J, Saldarriaga EM, Chávez-Gómez R, Gálvez-Inga J, Valdivia-Vega R, Villavicencio-Carranza M, et al. Effectiveness of adherence to a renal health program in a health network in Peru. Rev Saude Publica. 2020;54:80. https://doi.org/10.11606/s1518-8787.2020054002109
Murton M, Goff-Leggett D, Bobrowska A, Garcia Sanchez JJ, James G, Wittbrodt E, et al. Burden of chronic kidney disease by KDIGO categories of glomerular filtration rate and albuminuria: a systematic review. Adv Ther. 2021;38(1):180-200. https://doi.org/10.1007/s12325-020-01568-8
López Escudero PJ, Pompa Gutiérrez Z, Álvarez Vázquez B. Caracterización de pacientes con infecciones bacterianas asociadas al catéter para hemodiálisis. Rev Cubana Med Militar. 2021;50(4):02101481. https://revmedmilitar.sld.cu/index.php/mil/article/view/1481
Hughes JT, Freeman N, Beaton B, Puruntatemeri AM, Hausin M, Tipiloura G, et al. My experiences with kidney care: A qualitative study of adults in the Northern Territory of Australia living with chronic kidney disease, dialysis and transplantation. PLoS One. 2019;14(12):e0225722. https://doi.org/10.1371/journal.pone.0225722
Quori A, Molina-Cabrillana J, Baamonde-Laborda E, García-Cantón C, Lago-Alonso MM, Toledo-González A, et al. Vigilancia de infecciones y otros eventos adversos en pacientes en hemodiálisis en el área sur de Gran Canaria. Nefrología. 2011;31(4):457-63. https://www.revistanefrologia.com/es-vigilancia-infecciones-otros-eventos-adversos-articulo-X0211699511052219
Hinostroza-Sayas J, Huaringa-Marcelo J, Guzmán-Ramos R, Vásquez-Grande G, Pérez-Arteaga L, Pérez-Tejada E, et al. Guía de práctica clínica para la prevención, diagnóstico y manejo de infecciones asociadas al acceso de hemodiálisis en el Seguro Social de Salud del Perú (EsSalud). Rev Cuerpo Med HNAAA. 2022;15(1):97-107. http://dx.doi.org/10.35434/rcmhnaaa.2022.151.1426
Ibáñez Franco EJ, Fretes Ovelar AMC, Duarte Arévalos LE, Giménez Vázquez FJ, Olmedo Mercado EF, Figueredo Martinez HJ, et al. Factores de riesgo asociados a infección de catéter de hemodiálisis en un centro de referencia. Rev Virtual Soc Parag de Med Int. 2022;9(1):23-33. https://doi.org/10.18004/rvspmi/2312-3893/2022.09.01.23
Linares-Artigas JC, Gotera-Zambrano JL, Estraño-Villanueva JF, Bermúdez-Aguillon HR. Infecciones asociadas al catéter de hemodiálisis en pacientes nefrópatas. Kasmera. 2020;48(2):e48232825. https://doi.org/10.5281/zenodo.4271376
Casares-Cid S, Goncalves-Vázquez PN, Alonso-González A, Remigio-Lorenzo MJ, Vázquez-Rivera J, Martínez-Ques ÁA. Relación entre calidad de vida, adherencia al tratamiento y nivel de conocimiento del paciente en hemodiálisis. Enferm Nefrol. 2022;25(2):140-8. https://dx.doi.org/10.37551/52254-28842022015
Centro Nacional de Salud Renal - EsSalud. Informe del Registro Nacional de Diálisis de EsSalud RENDES, prevalencia y morbilidad 2018. Perú: Centro Nacional de Salud Renal – EsSalud; 2022. http://www.essalud.gob.pe/wp-content/uploads/CNSR_Informe_RENDES_2018103_2022.pdf
Rubio Rubio MV, Lou Arnal LM, Gimeno Orna JA, Munguía Navarro P, Gutiérrez-Dalmau A, Lambán Ibor E, et al. Supervivencia y calidad de vida en pacientes ancianos en tratamiento renal conservador. Nefrología. 2019;39(2):141-50. https://doi.org/10.1016/j.nefro.2018.07.009
Gracia García O, Lou Arnal LM, Abad Díez JM, Álvarez Lipe R, Pérez y Pérez J, García Mena M, et al. Mortalidad durante el primer año y cumplimiento de los estándares de calidad de los pacientes incidentes en tratamiento renal sustitutivo en Aragón. Diál Traspl. 2017;38(1):57-63.
Mojena-Roblejo M, Suárez-Roblejo A, Ruíz-Ruíz Y, Blanco-Barbeito N, Carballo-Machado RA. Complicaciones más frecuentes en pacientes con insuficiencia renal crónica terminal sometidos a hemodiálisis. Revista Electrónica Dr Zoilo E Marinello Vidaurreta. 2018;43(3). https://revzoilomarinello.sld.cu/index.php/zmv/article/view/1275
Kumbar L, Yee J. Current concepts in hemodialysis vascular access infections. Adv Chronic Kidney Dis. 2019;26(1):16-22. https://doi.org/10.1053/j.ackd.2018.10.005
Sahli F, Feidjel R, Laalaoui R. Hemodialysis catheter-related infection: rates, risk factors and pathogens. J Infect Public Health. 2017;10(4):403-8. https://doi.org/10.1016/j.jiph.2016.06.008
Brítez Nuñez DV, Riveros Duré CD, Quintana Rotela AA, Martínez Ruiz Díaz M, Miskinich Lugo ME, Cabañas Cristaldo JD, et al. Evolución clínica del tratamiento empírico versus dirigido de la infección relacionada a catéter de hemodiálisis. Rev Virtual Soc Parag Med Int. 2022;9(2):55-65. https://doi.org/10.18004/rvspmi/2312-3893/2022.09.02.55
Acquier M, De Précigout V, Delmas Y, Dubois V, M’Zali F, Zabala A, et al. [Diagnosis and treatment of catheter-related bloodstream infection in hemodialysis: 10 years later]. Nephrol Ther. 2022;18(2). https://doi.org/10.1016/j.nephro.2021.08.010
Gómez J, Pimienta L, Pino RF, Hurtado M, Villaveces M. Prevalencia de infección asociada a catéter de hemodiálisis en el Hospital Universitario Clínica San Rafael. Rev Colomb Nefrol. 2018;5(1):17-25. https://doi.org/10.22265/acnef.5.2.283
Alhazmi SM, Noor SO, Alshamrani MM, Farahat FM. Bloodstream infection at hemodialysis facilities in Jeddah: a medical record review. Ann Saudi Med. 2019;39(4):258-64. https://doi.org/10.5144/0256-4947.2019.258
Yap HY, Pang SC, Tan CS, Tan YL, Goh N, Achudan S, et al. Catheter-related complications and survival among incident hemodialysis patients in Singapore. J Vasc Access. 2018;19(6):602-8. https://doi.org/10.1177/1129729818765055
Chaudry MS, Gislason GH, Kamper AL, Rix M, Larsen AR, Petersen A, et al. Increased risk of Staphylococcus aureus bacteremia in hemodialysis-A nationwide study. Hemodial Int. 2019;23(2):230-8. https://doi.org/10.1111/hdi.12728
Lafuente Cabrero E, Terradas Robledo R, Civit Cuñado A, García Sardelli D, Hidalgo López C, Giro Formatger D, et al. Risk factors of catheter-associated bloodstream infection: Systematic review and meta-analysis. PLoS One. 2023;18(3):e0282290. https://doi.org/10.1371/journal.pone.0282290
Machado-Villarroel L, Montano-Candia M, Dimakis-Ramírez DA. Diabetes mellitus y su impacto en la etiopatogenia de la sepsis. Acta Méd Grupo Ángeles. 2017;15(3):207-15. https://doi.org/10.35366/74391
Rhee JJ, Zheng Y, Liu S, Montez-Rath ME, Hamill RJ, Ishida JH, et al. Glycemic control and infections among US hemodialysis patients with diabetes mellitus. Kidney Int Rep. 2020;5(7):1014-25. https://doi.org/10.1016%2Fj.ekir.2020.04.020
Delistefani F, Wallbach M, Müller GA, Koziolek MJ, Grupp C. Risk factors for catheter-related infections in patients receiving permanent dialysis catheter. BMC Nephrol. 2019;20(1):199. https://doi.org/10.1186/s12882-019-1392-0
Amaral Schwanke A, Reichembach Danski MT, Pontes L, Kusma SZ, Lind J. Central venous catheter for hemodialysis: incidence of infection and risk factors. Rev Bras Enferm. 2018;71(3):1115-21. https://doi.org/10.1590/0034-7167-2017-0047
Invernizzi Prats JM, Álvarez Ovelar RD, Jatchuk Luchuk AM, Gaona Lerea MB, Barreto Ríos MN, Zacarías Crovato AM. Caracterización clínico epidemiológica de las infecciones relacionadas con catéter de hemodiálisis en pacientes en terapia sustitutiva renal en un hospital nacional de referencia. Rev Investig Cient Tecnol. 2020;4(2):14-23. https://doi.org/10.36003/Rev.investig.cient.tecnol.V4N2(2020)2
De Clerck D, Bonkain F, Cools W, Van der Niepen P. Vascular access type and mortality in haemodialysis: a retrospective cohort study. BMC Nephrol. 2020;21(1):231. https://doi.org/10.1186/s12882-020-01889-4
Lemaire X, Morena M, Leray-Moragués H, Henriet-Viprey D, Chenine L, Defez-Fougeron C, et al. Analysis of risk factors for catheter-related bacteremia in 2000 permanent dual catheters for hemodialysis. Blood Purif. 2009;28(1):21-8. https://doi.org/10.1159/000210034
Paraíso V, Merino JL, Ibeas J. Catéteres tunelizados para Hemodiálisis. En: Lorenzo V., López Gómez JM, editores. Nefrología al día. https://www.nefrologiaaldia.org/427
Hidalgo-Blanco MA, Moreno-Arroyo C, Sánchez-Ortega MA, Prats-Arimon M, Puig-Llobet M. Análisis de las complicaciones del acceso vascular en hemodiálisis. Una revisión sistemática. Enferm Nefrol. 2023;26(2):106-18. https://doi.org/10.37551/S2254-28842023011
Gimeno HV, Beneit MJV, Faraldo CA, Herrero CJ, Zaragoza GI, López MV, et al. Influencia de variables del manejo de catéteres venosos tunelizados en hemodiálisis sobre la tasa de bacteriemia: Estudio analítico observacional. Rev Nefrol Dial Traspl. 2022;42(4):285-295.
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