title: Morbimortality study of infection in patients undergoing different types of dialysis in a renal replacement therapy center.
abstract: BACKGROUND
  Renal replacement therapy is the treatment of end-stage chronic kidney disease and can be performed through dialysis catheters, arteriovenous fistulas/grafts, and peritoneal dialysis. Patients are usually immunocompromised and exposed to invasive procedures, leading to high rates of infection and increased mortality.
  
  
  OBJECTIVE
  To compare the prevalence of infection and related deaths, as well as the sensitivity profile of the putative bacteria in patients treated with peritoneal dialysis, arteriovenous fistula hemodialysis and catheter hemodialysis.
  
  
  METHODS
  This is case-control study. Six hundred forty-four patients undergoing renal replacement therapy were selected. Patients were divided into three groups according to the modality of dialysis treatment: peritoneal dialysis (126 patients), arteriovenous fistula hemodialysis (326 patients), and catheter hemodialysis (192 patients).
  
  
  RESULTS
  One hundred sixteen patients (18.01%) developed infection. There was a higher incidence of infection in the peritoneal dialysis group (44 patients; 34.92%; OR: 3.32; CI 95%=2.13-5.17; p=0.0001). In the catheter hemodialysis group, 48 patients (25%) had infection (OR: 1.88; CI 95%: 1.24-2.85; p=0.0035). In the arteriovenous fistula hemodialysis group, 24 patients (7.36%) developed infection (OR: 0.19; CI 95%: 0.12-0.31; p=0.0001). Five patients (4.31%) died due to infection (four in the peritoneal dialysis group and one in the catheter hemodialysis group). There were no deaths due to infection in the arteriovenous fistula hemodialysis group.
  
  
  CONCLUSIONS
  Peritoneal dialysis is the treatment with greater risk of infection and mortality, followed by catheter hemodialysis. The lowest risk of infection and mortality was observed in arteriovenous fistula hemodialysis group.
authors.affiliation: Universidade Estadual de Ponta Grossa, Medicine Department, Avenida General Carlos Cavalcanti 4748, CEP: 84030900 Ponta Grossa, Paraná, Brazil. Electronic address: natalia_ridao_curty@hotmail.com.
authors.forename: Natália Fabiane
authors.initials: NF
authors.lastname: Ridão Curty
authors.affiliation: Universidade Estadual de Ponta Grossa, Medicine Department, Avenida General Carlos Cavalcanti 4748, CEP: 84030900 Ponta Grossa, Paraná, Brazil.
authors.forename: Lucilene Fagundes
authors.initials: LF
authors.lastname: da Silva Martins
authors.affiliation: Universidade Estadual de Ponta Grossa, Pharmacy and Biochemistry Department, Brazil.
authors.forename: Carmen Antônia
authors.initials: CA
authors.lastname: Sanches Ito
authors.affiliation: Universidade Estadual de Ponta Grossa, Medicine Department, Avenida General Carlos Cavalcanti 4748, CEP: 84030900 Ponta Grossa, Paraná, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Schafranski
authors.affiliation: Hospital Santa Casa de Misericórdia de Ponta Grossa, Hospital Infection Control, Brazil.
authors.forename: Dorelayne Aparecida
authors.initials: DA
authors.lastname: Brites
authors.affiliation: Universidade Estadual de Ponta Grossa, Medicine Department, Avenida General Carlos Cavalcanti 4748, CEP: 84030900 Ponta Grossa, Paraná, Brazil.
authors.forename: César Roberto
authors.initials: CR
authors.lastname: Busato
mesh_terms: D016022:Case-Control Studies; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000401:mortality; D016908:Gram-Positive Bacterial Infections / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods / Q000401:mortality*; D051436:Renal Insufficiency, Chronic / Q000382:microbiology / Q000401:mortality* / Q000628:therapy; D012307:Risk Factors
keywords: Bacteria; Hemodialysis; Hospital infection; Morbimortality; Renal replacement therapy center; Sensitivity profiles