Abstract:
Introduction: Central venous catheter (CVC)-related infection is the main complication observed in patients undergoing hemodialysis with this type of venous access.
Objective: To estimate the incidence of non-tunneled CVC-related bacteremia, analyze the frequency of causative agents, and explore associated risk factors in children undergoing hemodialysis.
Population and methods: Retrospective study in children receiving hemodialysis via a non-tunneled CVC between June 1st, 2015 and June 30th, 2019. A logistic regression was carried out to assess risk factors that were predictors of CVC-related bacteremia. Independent risk factors were described as odds ratios with their corresponding 95% confidence interval (CI). A value of p < 0.05 was considered statistically significant.
Results: A total of 121 non-tunneled CVCs were included in this study. The incidence of bacteremia was 3.15 per 1000 catheter-days. The most commonly isolated microorganism was Staphylococcus epidermidis (16 cases, 51.5%). Prior catheter infection was the only independent risk factor for the development of bacteremia associated with non-tunneled CVC (OR: 2.84, 95% CI: 1.01-7.96, p = 0.04).
Conclusions: Prolonged use of non-tunneled CVCs for chronic hemodialysis was associated with a low incidence of bacteremia. Gram-positive microorganisms prevailed among causative agents. A prior CVC infection almost trebled the risk for CVC-related bacteremia in our pediatric population receiving hemodialysis.
Reference:Di Pinto D, Adragna M, Mamani J, Mendoza L, Maita G, Rodríguez S, Álvarez M, Bustamante R, D’Alessandro P, López L. Bacteremia associated with non-tunneled central venous catheters in children undergoing chronic hemodialysis. Arch Argent Pediatr. 2024 Mar 14:e202310259. English, Spanish. doi: 10.5546/aap.2023-10259.eng. Epub ahead of print. PMID: 38457237.