title: Bacteremia in hemodialysis and peritoneal dialysis patients.
abstract: OBJECTIVE
  To analyze the incidence rates and risk factors for bacteremia in patients undergoing hemodialysis (HD) and peritoneal dialysis (PD).
  
  
  METHODS
  The records of 898 consecutive patients undergoing dialysis from January 2003 to December 2008 were reviewed retrospectively. Episodes of bacteremia were recorded. China Medical University (Taichung, Taiwan).
  
  
  RESULTS
  The overall incidence rate of bacteremia was 7.63 per 100 patient-years in HD patients and 3.56 per 100 patient-years in PD patients and it was higher in HD patients each year from 2003 to 2008. S. aureus (27.53%) was the most common pathogen in HD patients, whereas Coagulase-negative Staphylococcus (21.3%) was the most common pathogen in PD patients. Vascular access infection was the most common etiology in HD patients, whereas peritonitis was the most common etiology in PD patients. Older age, shorter dialysis vintage, use of HD rather than PD, current smoker, use of a venous dialysis catheter, presence of diabetes mellitus, higher comorbidity score, and lower serum albumin were significant risk factors for bacteremia. Diabetes mellitus and lower serum albumin were significant risk factors for bacteremia-associated mortality.
  
  
  CONCLUSIONS
  Placement of a permanent access (fistula, graft, or PD catheter) prior to initiation of dialysis, smoking cessation, and better nutritional status (i.e. higher serum albumin) were associated with a reduced risk of bacteremia in dialysis patients. Higher serum albumin was also associated with a reduced bacteremia-associated mortality.
authors.affiliation: Division of Nephrology, China Medical University Hospital, Taiwan.
authors.forename: I-Kuan
authors.initials: IK
authors.lastname: Wang
authors.forename: Yi-Chih
authors.initials: YC
authors.lastname: Chang
authors.forename: Chih-Chia
authors.initials: CC
authors.lastname: Liang
authors.forename: Feng-Rong
authors.initials: FR
authors.lastname: Chuang
authors.forename: Chiz-Tzung
authors.initials: CT
authors.lastname: Chang
authors.forename: Hsin-Hung
authors.initials: HH
authors.lastname: Lin
authors.forename: Chung-Chih
authors.initials: CC
authors.lastname: Lin
authors.forename: Tzung-Hai
authors.initials: TH
authors.lastname: Yen
authors.forename: Po-Chang
authors.initials: PC
authors.lastname: Lin
authors.forename: Che-Yi
authors.initials: CY
authors.lastname: Chou
authors.forename: Chiu-Ching
authors.initials: CC
authors.lastname: Huang
authors.forename: Wen-Chen
authors.initials: WC
authors.lastname: Tsai
authors.forename: Jin-Hua
authors.initials: JH
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors