Outcome following haemodialysis catheter-related Staphylococcus aureus bacteraemia.
Staphylococcus aureus is a frequent cause of haemodialysis access-related bacteraemia. The propensity for this organism to seed from the bloodstream to distant sites is well recognized, but the rate at which this occurs is poorly defined in patients with removable haemodialysis catheters. This retrospective study identified 47 patients with 50 episodes of S. aureus haemodialysis catheter-related bacteraemia between August 1993 and December 1995. Adverse events were recorded until February 1996. Thirty of 50 episodes (60%) were apparently uncomplicated. Bacterial seeding to heart valves or distant sites was documented in eight episodes (16%), of which six occurred during antibiotic therapy. A further 12 patients had persistent bacteraemia in the absence of a defined focus of infection, the last positive blood culture ranging from 2-19 days (mean 6.6, median 5) after removal of the haemodialysis catheter and commencing appropriate antibiotic treatment. The serious nature of this infection confirms the need for prevention, together with effective strategies for investigation and treatment in this patient population.
Peacock
S J
SJ
Nuffield Department of Medicine, John Radcliffe, Oxford Radcliffe Hospital NHS Trust, Headington, UK.
Curtis
N
N
Berendt
A R
AR
Bowler
I C
IC
Winearls
C G
CG
Maxwell
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy* / Q000209:etiology; D002404:Catheterization; D002408:Catheters, Indwelling / Q000009:adverse effects*; D003428:Cross Infection / Q000188:drug therapy* / Q000209:etiology; D004739:England; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D017053:Infection Control; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000295:instrumentation*; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000209:etiology; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents