Catheter-related infections in continuous hemodiafiltration in intensive care patients.
OBJECTIVE
Infection control is of key importance especially in the application of long-term continuous hemodiafiltration (CHDF) involving invasive vascular catheterization to critically ill patients. We investigated hemodialysis catheter-related infections in long-term CHDF.


METHODS
We examined catheter infections in 54 patients who were admitted to the intensive care unit and underwent CHDF for 2 weeks or longer.


RESULTS
With a total of 155 catheters (1,071 catheter days) studied, catheter colonization and catheter-related bloodstream infection were noted with an incidence rate of 4.8 and 2.7 per 1,000 catheter days, respectively. No difference in catheter colonization rate was observed depending on the catheterization sites or duration of catheterization. Infections were identified in 39 patients (72%) and blood culture positivity was noted in 25 patients (46%).


CONCLUSIONS
Since the majority of cases requiring long-term CHDF are complicated with a variety of infections, it is difficult to control infections associated with hemodialysis catheters separately from infections of other types. Systemic infection control should serve as a strategy finally leading to successful control of catheter-related infection.
Department of Emergency and Critical Care Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan. taka.nakada@nifty.com
Taka-aki
TA
Nakada
Hiroyuki
H
Hirasawa
Shigeto
S
Oda
Hidetoshi
H
Shiga
Kazuya
K
Nakanishi
Ken-Ichi
K
Matsuda
Masataka
M
Nakamura
Masayuki
M
Shima
Masaharu
M
Watanabe
D002404:Catheterization / Q000009:adverse effects*; D004866:Equipment Contamination; D017583:Hemodiafiltration / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007239:Infections / Q000209:etiology*; D007362:Intensive Care Units; D008828:Microbiological Techniques; D012189:Retrospective Studies; D012698:Serologic Tests