[Dialin: infection surveillance network for haemodialysis patients. First results].
OBJECTIVE
To show results of the first year of an infection surveillance network for haemodialysis patients (Dialin). In order to improve the security and quality of care, six haemodialysis centers have organized an infection watching network. The purpose of the network is to compare of the watching results between centers. This comparison includes vascular access infection (VAI), bacteraemia and C viral hepatitis. The heterogeneous pattern has been also taken into account. SURVEY TYPE: Multicenter prospective permanent survey.


METHODS
Six hundred and sixty-four haemodialyzed chronic patients, followed during one year (2005), in six voluntary haemodialysis centers. This survey has based on 71,688 treatment sessions corresponding to 6257.5 months of haemodialysis (HM).


METHODS
As with the heterogeneity among centers, the acquired infection standardized ratios (observed/expected) (AISR) and 95% confidence interval are computed with Cox model which includes confounding factors found in literature or in the preliminary stage of the survey.


RESULTS
VAI crude rate was 0.47 per 100HM, 0.10 per 1000 native fistulae utilisation days, 0.45 per 1000 days of prosthetic graft utilisation and 0.44 per 1000 days of catheter utilisation. Bacteraemia crude incidence rate was 0.69 per 100HM, 0.02 per 1000 days of native fistulae utilisation, 0.00 per 1000 days of prosthetic graft utilisation and 0.39 per 1000 days of catheter utilisation. No new case of C viral hepatitis was found. Prevalence rate at the beginning of the survey was 5.3% (35 over 664). Two centers had a significantly high AISR for VAI and two centers had a significantly low AISR for VAI. One center had a significantly high AISR for bacteraemia and one center had a significantly low AISR for bacteraemia.


CONCLUSIONS
The first year of Dialin running demonstrates the importance of standardised surveillance method in VAI and bacteraemia surveillance but not for viral hepatitis.
Ayzac
Louis
L
CCLIN Sud-Est, hôpital Henry-Gabrielle, villa Alice, 20, route de Vourles, BP 57, 69565 Saint-Genis-Laval cedex, France. louis.ayzac@chu-lyon.fr
Béruard
Michel
M
Girard
Raphaële
R
Hannoun
Jacques
J
Kuentz
François
F
Marc
Jean-Michel
JM
Moreau-Gaudry
Xavier
X
Roche
Catherine
C
Tressières
Benoît
B
Uzan
Marc
M
D000368:Aged; D055499:Catheter-Related Infections / Q000453:epidemiology*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D011159:Population Surveillance; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D012307:Risk Factors