title: Bacteremia in hemodialysis patients.
abstract: Infection is a common complication and is the second leading cause of death in hemodialysis patients. The risk of bacteremia in hemodialysis patients is 26-fold higher than in the general population, and 1/2-3/4 of the causative organisms of bacteremia in hemodialysis patients are Gram-positive bacteria. The ratio of resistant bacteria in hemodialysis patients compared to the general population is unclear. Several reports have indicated that hemodialysis patients have a higher risk of methicillin-resistantStaphylococcus aureusinfection. The most common site of infection causing bacteremia is internal prostheses; the use of a hemodialysis catheter is the most important risk factor for bacteremia. Although antibiotic lock of hemodialysis catheters and topical antibiotic ointment can reduce catheter-related blood stream infection (CRBSI), their use should be limited to necessary cases because of the emergence of resistant organisms. Systemic antibiotic administration and catheter removal is recommended for treating CRBSI, although a study indicated the advantages of antibiotic lock and guidewire exchange of catheters over systemic antibiotic therapy. An infection control bundle recommended by the Center for Disease Control and Prevention succeeded in reducing bacteremia in hemodialysis patients with either a catheter or arteriovenous fistula. Appropriate infection control can reduce bacteremia in hemodialysis patients.
authors.affiliation: Masashi Suzuki, Nobuhiko Satoh, Motonobu Nakamura, Shoko Horita, Kyoji Moriya, Department of Internal Medicine, the University of Tokyo Hospital, Bunkyo-ku, Tokyo 113-0033, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: Masashi Suzuki, Nobuhiko Satoh, Motonobu Nakamura, Shoko Horita, Kyoji Moriya, Department of Internal Medicine, the University of Tokyo Hospital, Bunkyo-ku, Tokyo 113-0033, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Satoh
authors.affiliation: Masashi Suzuki, Nobuhiko Satoh, Motonobu Nakamura, Shoko Horita, Kyoji Moriya, Department of Internal Medicine, the University of Tokyo Hospital, Bunkyo-ku, Tokyo 113-0033, Japan.
authors.forename: Motonobu
authors.initials: M
authors.lastname: Nakamura
authors.affiliation: Masashi Suzuki, Nobuhiko Satoh, Motonobu Nakamura, Shoko Horita, Kyoji Moriya, Department of Internal Medicine, the University of Tokyo Hospital, Bunkyo-ku, Tokyo 113-0033, Japan.
authors.forename: Shoko
authors.initials: S
authors.lastname: Horita
authors.affiliation: Masashi Suzuki, Nobuhiko Satoh, Motonobu Nakamura, Shoko Horita, Kyoji Moriya, Department of Internal Medicine, the University of Tokyo Hospital, Bunkyo-ku, Tokyo 113-0033, Japan.
authors.forename: George
authors.initials: G
authors.lastname: Seki
authors.affiliation: Masashi Suzuki, Nobuhiko Satoh, Motonobu Nakamura, Shoko Horita, Kyoji Moriya, Department of Internal Medicine, the University of Tokyo Hospital, Bunkyo-ku, Tokyo 113-0033, Japan.
authors.forename: Kyoji
authors.initials: K
authors.lastname: Moriya
keywords: Bacteremia; Blood stream infection; Epidemiology; Hemodialysis; Infection control