title: Prevention and management of catheter-related infection in hemodialysis patients.
abstract: Central venous catheter-related infections have been associated with high morbidity, mortality, and costs. Catheter use in chronic hemodialysis patients has been recognized as distinct from other patient populations who require central venous access, leading to recent adaptations in guidelines-recommended diagnosis for catheter-related bacteremia (CRB). This review will discuss the epidemiology and pathogenesis of hemodialysis CRB, in addition to a focus on interventions that have favorably affected CRB outcomes. These include: (1) the use of prophylactic topical antimicrobial ointments at the catheter exit site, (2) the use of prophylactic catheter locking solutions for the prevention of CRB, (3) strategies for management of the catheter in CRB, and (4) the use of vascular access managers and quality initiative programs.
authors.affiliation: Division of Nephrology, Department of Medicine, Toronto General Hospital and The University of Toronto, Toronto, Ontario, Canada. Electronic address: charmaine.lok@uhn.on.ca.
authors.forename: Charmaine E
authors.initials: CE
authors.lastname: Lok
authors.affiliation: Division of Nephrology, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Michele H
authors.initials: MH
authors.lastname: Mokrzycki
mesh_terms: D019072:Antibiotic Prophylaxis / Q000191:economics; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000191:economics / Q000295:instrumentation; D002408:Catheters, Indwelling / Q000009:adverse effects* / Q000191:economics; D019033:Delivery of Health Care, Integrated; D017048:Health Care Costs; D006801:Humans; D017053:Infection Control / Q000191:economics / Q000379:methods*; D017410:Practice Guidelines as Topic; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D006435:Renal Dialysis / Q000009:adverse effects* / Q000191:economics / Q000295:instrumentation; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome