oa Southern African Journal of Infectious Diseases - Haemodialysis catheter-related bloodstream infections at Universitas Academic Hospital, Bloemfontein : should we change our empiric antibiotics? : original research
Nosocomial bloodstream infections are only second to cardiovascular disease in causing mortality in patients with end-stage renal disease. The majority of these infections relate to haemodialysis catheters. Empiric antimicrobial treatment is instituted on the clinical suspicion of a catheter-related bloodstream infection (CRBSI) while awaiting the blood culture results. There is a paucity of local data on microbial resistance patterns to guide empiric antibiotic use. This prompted our study. A retrospective survey was performed of cultured organisms and their antibiograms from patients with haemodialysis catheters in the Nephrology Unit at Universitas Academic Hospital, Bloemfontein, between January and December 2012. A list of all blood cultures performed during 2012 at the nephrology unit was compiled from the National Health Laboratory Service's electronic record system. All positive blood cultures associated with CRBSI were included in this study. Duplicate cultures, as well as negative cultures, were excluded. Demographic details were collected from the patient records. There were 79 episodes of suspected CRBSI in the 311 patients dialysed in 2012. Thirty-one distinct episodes of culture-positive, catheter-related infections were identified from 296 blood cultures. These were equally divided between tunnelled and non-tunnelled catheters. There were 15 Staphylococcus spp., eight of which were methicillin resistant, five Enterococcus spp., and three extended-spectrum beta-lactamase (ESBL)-producing Enterobacter spp. There was one episode each of various other organisms. Vancomycin and amikacin remain the empiric treatment for CRBSI in our unit. The emergence of ESBL-related infections should be monitored.
Article metrics loading...