title: Surveillance of chronic haemodialysis-associated infections in southern Israel.
abstract: During a 12-month surveillance period, haemodialysis (HD) patients in southern Israel were categorised according to the type of vascular access site (VAS), i.e., arteriovenous (AV) fistula, synthetic AV graft, and cuffed or non-cuffed vascular catheters. Endpoints, expressed as cases/100 patient-months, were: incidence of hospital admission; antibiotic therapy; bloodstream infection (BSI); and VAS infection. These were compared to Centers for Disease Control (CDC) surveillance data, overall and by VAS type. In total, 2568 patient-months were analysed. The VAS distribution differed significantly from CDC data for fistulas (72% vs. 31%), grafts (12% vs. 41%), cuffed catheters (11% vs. 25%) and non-cuffed catheters (5% vs. 3%) (p < 0.0001 in all cases). Of 151 admissions, 32% resulted from infection, for which 112 antibiotic courses (22% vancomycin) were given. There were 16 BSIs, three involving resistant strains. The incidences of admission, antibiotic therapy, BSI and VAS infection were significantly lower overall, compared to CDC rates, as were most VAS-specific endpoints. These differences may be explained by VAS type distribution, although other factors may also be involved. Reporting regional or national surveillance data may allow a standardised comparison of the incidence of HD-associated infections.
authors.affiliation: Department of Internal Medicine, Infection Control Unit, Soroka University Medical Center, Beer-Sheva, Israel. giladko@bgumail.bgu.ac.il
authors.forename: J
authors.initials: J
authors.lastname: Gilad
authors.forename: S
authors.initials: S
authors.lastname: Eskira
authors.forename: F
authors.initials: F
authors.lastname: Schlaeffer
authors.forename: M
authors.initials: M
authors.lastname: Vorobiov
authors.forename: A
authors.initials: A
authors.lastname: Marcovici
authors.forename: D
authors.initials: D
authors.lastname: Tovbin
authors.forename: M
authors.initials: M
authors.lastname: Zlotnik
authors.forename: A
authors.initials: A
authors.lastname: Borer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia; D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D002404:Catheterization; D002408:Catheters, Indwelling / Q000382:microbiology; D004351:Drug Resistance; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D006435:Renal Dialysis
chemical_list: D000900:Anti-Bacterial Agents