title: [Infections from extemporaneous catheters for hemodialysis. Experience in a center].
abstract: OBJECTIVE
  This study reports a retrospective evaluation of the predominance of infection in 67 dual lumen central venous catheters (CVC), 35 of which were positioned in the femoral vein by the nephrological team and 32 in the subclavian vein by anesthetists.
  
  
  METHODS
  The microorganisms responsible for infection, the prevalence of clinically symptomatic infections, the relationship between CVC-correlated infection and the time the catheter remained inserted were evaluated, together with a comparison between the two different insertion sites.
  
  
  RESULTS
  Culture tests, performed using Maki's semiquantitative technique, gave positive results in 16/67 (23.8%) cases. The main pathogenic agents found were Staphylococcus epidermidis (37.5%) and Staphylococcus aureus (31.2%). In 3/16 cases (18.78%) infections were clinically symptomatic. The mean permanence of CVC with positive cultures was not statistically different to the mean permanence of CVC with negative cultures (22.44 +/- 13.48 vs 18.38 +/- 17.76). The microorganisms isolated on femoral and subclavian catheters showed a comparable distribution and the prevalence of infection was not statistically different in the two insertion sites.
  
  
  CONCLUSIONS
  In conclusion, in the absence of infection, the authors tend to keep working catheters in the site, thus avoiding repeated invasive manoeuvres for replacement and/or repositioning, whereas in the presence of suspected systemic infection they feel it is more prudent to remove the CVC without waiting for the results of the hemoculture, starting first empiric and then specific antibiotic treatment on the basis of the antibiogram.
authors.affiliation: Servizio di Nefrologia e Dialisi, Ospedale Sant'Andrea, Vercelli.
authors.forename: S
authors.initials: S
authors.lastname: Ottone
authors.forename: P
authors.initials: P
authors.lastname: Cecere
authors.forename: P
authors.initials: P
authors.lastname: Colombo
authors.forename: M
authors.initials: M
authors.lastname: Porcu
authors.forename: O
authors.initials: O
authors.lastname: Filiberti
authors.forename: L
authors.initials: L
authors.lastname: Costantini
authors.forename: G C
authors.initials: GC
authors.lastname: Guazzotti
authors.forename: G
authors.initials: G
authors.lastname: Cagna
authors.forename: C
authors.initials: C
authors.lastname: Peona
mesh_terms: D001424:Bacterial Infections / Q000382:microbiology*; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D012189:Retrospective Studies
vernacular_title: Infezione dei cateteri estemporanei per emodialisi. Esperienza di un centro.