title: [Have we forgotten the most important thing to prevent bacteremias associated with tunneled hemodialysis catheters?].
abstract: Bacteremia associated with tunneled central venous catheters (CVC) is a major complication in hemodialysis patients. Strategies that aim to prevent catheter-related bacteremia (CRB), ranging from the application of topical antibiotics to the use of different catheter-lock solutions, have been studied, but limited interest has been shown about following standardization of aseptic care and maintenance of CVC by experienced staff. This study reports CRB incidence obtained with a strict infection prophylaxis protocol based on universal precautions against infection adopted in our Unit by qualified nursing hemodialysis staff. During a period of 20 months, 32 patients received 42 CVC. There were 2 CRB, with an incidence of 0.24 CRB/1000 days-catheter. This study shows that an optimal catheter-use management reduces the incidence of CRB to excellent rates. The use of a protocol directed to vigorously protect the catheter at the time of usage by specialized teams is critically important and is highly recommended.
authors.affiliation: Servicio de Nefrología, Hospital Infanta Leonor, Madrid. malbalater@senefro.org
authors.lastname: Albalate
authors.forename: R
authors.initials: R
authors.lastname: Pérez García
authors.forename: P
authors.initials: P
authors.lastname: de Sequera
authors.forename: R
authors.initials: R
authors.lastname: Alcázar
authors.forename: M
authors.initials: M
authors.lastname: Puerta
authors.forename: M
authors.initials: M
authors.lastname: Ortega
authors.forename: A
authors.initials: A
authors.lastname: Mossé
authors.forename: E
authors.initials: E
authors.lastname: Crespo
mesh_terms: D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D005334:Fever / Q000209:etiology; D019983:Guideline Adherence; D006757:Hospital Units / Q000706:statistics & numerical data; D006801:Humans; D006435:Renal Dialysis / Q000295:instrumentation* / Q000451:nursing; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D016635:Universal Precautions