Infection associated with double lumen catheterization for temporary haemodialysis: experience of 168 cases.
A total of 227 patients with renal failure requiring acute haemodialysis with placement of a total of 260 Medcorp double lumen catheters at National Taiwan University Hospital from July 1992 to July 1993 were reviewed. Among them, only 135 patients receiving a total of 168 catheter placements and a complete infectious work-up were selected for this study. The mean age of the patients was 55 years (range 15-89 years); 63 (46.7%) were male and 75 (53.3%) were female. The three major reasons for dialysis were chronic glomerular disease (CGN; 49%), diabetic nephropathy (13%) and nephritis associated with systemic lupus erythematosus (SLE; 11%). The catheters remained in place for an average of 27.8 days (9-73 days) and each catheter was used for an average of eight treatments (2-26). The reasons for catheter removal were classified as: availability of permanent vascular access (48%), recovery of renal function (10%), scheduled duration (30 days, not every case; 4%), expiration of patient (10%), suspicion of catheter-related infections (15%), and catheter thrombosis/occlusion (9%). Seven cases with local haematoma and one case of pneumothorax were also identified (total 5%). In total, a 21.4% catheter-related infection rate was observed and micro-organisms such as Staphylococcus aureus (33%), coagulase-negative staphylococci (36%) and Enterococcus (19%) were isolated. The cumulative probability of patients remaining free from catheter-related infections was about 75% by the end of the fourth week post-catheter insertion, and decreased to less than 50% near the end of the second month of persistent catheterization.(ABSTRACT TRUNCATED AT 250 WORDS)
Hung
K Y
KY
Department of Internal Medicine, National Taiwan University Hospital, ROC.
Tsai
T J
TJ
Yen
C J
CJ
Yen
T S
TS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003428:Cross Infection / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000295:instrumentation*; D051437:Renal Insufficiency / Q000150:complications / Q000628:therapy; D012307:Risk Factors