血液透析患者导管相关血流感染的发生率、风险因素、病原体类型和结果。

IF 1 Q3 MEDICINE, GENERAL & INTERNAL
Cureus Pub Date : 2024-09-16 eCollection Date: 2024-09-01 DOI:10.7759/cureus.69554
Adam Bitunguramye, Gerard Nkundimana, Ahmed M Aboubasha, Jules Kabahizi, William Rutikanga, Laetitia Nshimiyimana, Michel G Rafiki
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引用次数: 0

摘要

背景 因终末期肾病 (ESRD) 而接受血液透析的患者面临血液透析导管相关血流感染 (CRBSI) 的风险。本研究评估了卢旺达费萨尔国王医院接受维持性血液透析的成年患者中 CRBSI 的发病率、风险因素、病原体类型和结果。方法 这是一项前瞻性队列研究,研究对象是在卢旺达费萨尔国王医院通过中心静脉血液透析导管进行血液透析的终末期肾病成年患者。在获得 IRB 批准后,81 名符合条件的男女患者被纳入研究,他们的年龄在 19 岁至 74 岁之间。限制平均生存时间(RMST)分析评估了CRBSI的风险因素。统计意义采用 P 值,以 0.05 为界限。结果 每 1,000 个导管日的 CRBSI 发生率为 0.78 次。急性血液透析导管类型和贫血与 CRBSI 风险增加有关,P 值小于 0.05。此外,所有 CRBSI 病例均由细菌引起,其中 52.63% 为革兰氏阴性菌,47.37% 为革兰氏阳性菌。在 19 例 CRBSI 事件中,有 9 例(47.37%)需要住院治疗,中位住院时间为 7 天。大约一半的 CRBSI 需要拔除导管。没有发现转移性感染或死亡病例。结论 本研究表明,我们的血液透析室每 1,000 个导管日的发病率为 0.78 例。导管类型和贫血与 CRBSI 有显著相关性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Incidence, Risk Factors, Organism Types, and Outcomes of Catheter-Related Bloodstream Infections in Hemodialysis Patients.

Background Patients undergoing hemodialysis for End-Stage Renal Disease (ESRD) are at risk for Hemodialysis Catheter-Related Bloodstream Infections (CRBSIs). This study evaluates the incidence, risk factors, organism types, and outcomes of CRBSI in adult patients on maintenance hemodialysis at King Faisal Hospital, Rwanda. Methods This was a prospective cohort study of adult patients with end-stage renal disease undergoing hemodialysis via central venous hemodialysis catheters at King Faisal Hospital, Rwanda. Upon receiving the IRB approval, 81 eligible patients, women, and men aged between 19 and 74, were enrolled. Restricted Mean Survival Time (RMST) analysis evaluated the risk factors for CRBSI. The statistical significance was determined using p-values, with a cut-off of 0.05. Results The incidence of CRBSI was found to be 0.78 episodes per 1,000 catheter-days. Acute hemodialysis catheter type and anemia were associated with increased risk for CRBSI, with a P-value less than 0.05. In addition, all CRBSI cases were due to bacteria, with 52.63% gram-negative and 47.37% gram-positive. Out of 19 CRBSI events, nine cases (47.37%) required hospitalization with a median duration of seven days. Approximately half of the CRBSIs required catheter removal. No metastatic infection or death was noted. Conclusion The present study demonstrated that our hemodialysis unit has an incidence of 0.78 episodes per 1,000 catheter-days. Catheter type and anemia were significantly associated with CRBSI.

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