1. Home
  2. Vol 50, No 3 (2018)
  3. Dharmayanti

Catheter-related Blood Stream Infection in a Patient with Hemodialysis

Anti Dharmayanti, Dalima Astrawinata

Abstract


A 31-year-old patient came to visit the outpatient clinic at the hospital for his routine twice-weekly hemodialyis (HD) session. During HD, the patient suddenly developed a fever with shivering. At that time, a diagnosis of catheter-related blood stream infection (CR-BSI) was developed, HD catheter or the catheter double lumen (CDL) was uninstalled and the patient was hospitalized. Results of culture withdrawn through the tip of catheter lumen and peripheral blood revealed identical microorganism, i.e. the Enterobacter cloacae. Diagnosis of CR-BSI in the present case was made based on the 2009 Infectious Disease Society of America (IDSA) criteria. In general, prevention measures for CR-BSI should be taken into account including education for patient, awareness of the health care providers who install the CDL, implementation of procedure for appropriate skin aseptic technique and best practice for HD catheter care, particularly on the exit site of the CDL to prevent the development of CR-BSI.


Keywords


catheter-related blood stream infection (CR-BSI); Infectious Disease Society of America (IDSA) criteria; catheter double lumen (CDL)

References


Fysaraki M, Samonis G, Valachis A, et al. Incidence, clinical, microbiological features and outcome of blood stream infection in patients undergoing hemodyalisis. Int J Med Sci. 2013;10(12):1632-8.

Tomlinson D, Mermel LA, Ethier MC, Matlow A, Gillmeister B, Sung L. Defining blood stream infections related to central venous catheters in patients with cancer: a systematic review. Clin Infect Dis. 2011: 53(10);697-704.

Fletcher S. Catheter related blood stream infection. Crit. Care Pain. 2005;5(2):49-50.

Association for Professionals in Infection Control. Guide to the elimination of catheter related bloodstream infections. Washington: APIC; 2009. p. 8-13.

Qureshi AL, Abid K. Frequency of catheter related infections in haemodialysed uraemic patients. J Pak Med Assoc. 2010;60(8):671-5.

Departemen Kesehatan Republik Indonesia. Pedoman pengendalian infeksi nosokomial di rumah sakit.Jakarta: Depkes RI; 2001. p. 53-61.

Barbosa D, Taminato M, Fram D, Grothe C, Belasco A. Prevention of catheter-related bloodstream infections in patients on hemodialysis. Infect Control. 2012;25: 81-92.

Marconi C, Lourdes M, Lyra JC, et al. Comparison between qualitative and semiquantitative catheter tip cultures: laboratory diagnosis of catheter related infections in new borns. Brazilian J Microbiol. 2008; 39:262-7.

Beekman SE, Diekema DJ, Huskins C, et al. Diagnosing and reporting of central line associated blood stream infection. Inf Control Hosp Epidemiol. 2012;33(9):875-82.

Mermel LA, Allon M, Bouza E, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter related infection: 2009 update by the infectious diseases society of America. Clin Infect Dis. 2009;49:1-45.

Chin G. Treatment of dyalisis catheter infection.Sydney: Kidney Health Australia; 2012. p. 1-9.

Kidney Disease Improvement Global Outcome. Clinical prctice guideline for the evaluation and management of chronic kidney disease. 2012. Kyowa: KDIGO 2012.

Saxena AK, Panbotra BR. Haemodyalisis catheter related blood stream infections: current treatment options and strategies for prevention. Swiss Med Wkly. 2005;135:127-38.

Wilcox TA. Catheter related blood stream infection.Semin Intervent Rad. 2009;26(2):139-43.

Deal EN, Micek ST, Ritchie DJ, Reichley RM, Dunne WM, Kollef MH. Predictors of inhospital mortality for bloodstream infections caused by Enterobacter species or Citrobacter freundii. J Clin Microbiol. 2007; 27(2):191-9.

Maki DG, Kluger DM, Crnich CJ. The risk of blood stream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clin Proc. 2006;81(9):1159-71.


Full Text: PDF

Refbacks

  • There are currently no refbacks.