Catheter-related sepsis in tunneled central venous catheters in hemodialysis
Abstract:
Introduction: Catheter-related infections significantly increase the morbidity and mortality of dialysis patients. Our study aimed to assess the incidence of catheter-related infections in tunneled central venous catheters at our dialysis center.
Materials and methods: We retrospectively analyzed the incidence of catheter-related bloodstream infections (CRBSI) and tunnel infections in patients with a tunneled central venous catheter inserted at Trbovlje General Hospital between January 2015 and August 2024. The indication for catheter insertion was a reduced left ventricular ejection fraction (< 30%), polymorbidity with a short life expectancy (< 1 year), or a condition of the vascular system that made construction of an arteriovenous fistula/graft impossible.
Results: We included 344 patients (average age 73 ± 13 years, 49% men). In all patients, we inserted a tunneled central venous catheter with a symmetrical tip in a retrograde manner (64% through the right jugular vein). During the observed period, there were 16 cases of CRBSI (after 10 (IQR 5 – 14) months) and 4 cases of catheter tunnel infection (after 9 (IQR 4 – 16) months). In all cases of CRBSI, the catheter was replaced. In the case of catheter tunnel infections, the outer part of the catheter was replaced, and the tunnel infection was treated locally. The incidence of CRBSI was 0.09/1,000 catheter days.
Conclusion: The incidence of CRBSI in our cohort was low, likely due to the implementation of preventive protocols for insertion and maintenance of tunneled central venous catheters.
Reference:
Furlan T, Terbovc K, Leskovar B. Single-center experience on catheter-related sepsis in tunneled central venous catheters in hemodialysis patients. Clin Nephrol. 2025 Nov 27. doi: 10.5414/CNP104S08. Epub ahead of print. PMID: 41307419.