Hemodialysis Catheter-Related Infection in a Teaching Hospital of Central Nepal

IntroductionInfection of the central venous catheter (CVC) is a major complication seen among patients undergoinghemodialysis. Identifying CVC related infection (CRI) and its risk factors and causative organisms is important for better implementation of preventive strategies.MethodsA prospective study was conducted at Chitwan Medical College for a duration of 2 years from January 2017to December 2018 among the patients undergoing hemodialysis via CVC. The data collected were related topatients’ demographics, site of catheter insertion, and duration, microbiological data including cultures fromcatheter sites, blood, and catheters’ tips and antibiotic sensitivity. Catheter related infection was divided intocatheter related local infection (CRLI) and catheter related blood stream infection (CRBSI). Data was analyzedusing IBM SPSS Statistics version 21.0.ResultsA total of 41 cases of CVC related infection (CRI) were documented with an incidence rate of 6.94 episodesper 1000 catheter days at risk. Out of the total CRI, 39.02% were CRLI and 60.98% were CRBSI. Fever with chillsand rigor were the most common clinical presentation. Risk factors for the development of CRI were durationof catheter in situ, repeated change of CVC and the use of CVC for indications other than hemodialysis (HD).Staphylococci and Klebsiella were the most common organisms isolated in culture.ConclusionThe rate of CRI among Nepalese patients undergoing hemodialysis is high. Prolonged duration of CVC usage,recent change of catheter and the use of the HD catheter for the purpose of institution of intravenous medication have been found as the risk factors for CRI.KeywordsCatheter related infection, central venous catheter, hemodialysis