Clinical characteristics and risk factors of dialysis catheter-related infection in CRRT patients
Xiaotian Liu, Hongjian Ye, Xunhua Zheng, Zhihua Zheng, Miaoqing Lu, Zhong Zhong, Cuifang Zhan, Suiqin Wen, Wei Chen, Xueqing Yu
Abstract
ObjectiveTo explore the clinical characteristics and risk factors of catheter-related infection in continuous renal replacement therapy (CRRT) patients.
MethodsThe demographic and clinical data of CRRT patients who inserted with double-lumen non-cuffed dialysis catheter at the First Affiliated Hospital of Sun Yat-sen University from January 1, 2016 to December 31, 2016 were collected. According to the presence or absence of catheter-related infections, they were divided into infected group and uninfected group. Statistics and analysis of the incidence and pathogenic characteristics of catheter-related infections; Comparison of clinical features of infected and uninfected groups; A multivariate Cox proportional hazard model was used to analyze risk factors for catheter-related infections.
ResultsA total of 364 patients with CRRT (437 cases of central venous catheterization) were enrolled in the study. Catheter-related bloodstream infection (CRBSI) and catheter-related colonization (CRCOL) rates were 3.565 and 2.228 events per 1000 catheter-days. These catheters were associated with higher proportion of inserted in ICU (P=0.007), immunosuppression (P=0.002), receive catecholamine inotropes therapy (P=0.001) and shock (P=0.030). The infection catheters also had shorter indwelling time (P=0.032) and lower level of blood hemoglobin (P=0.017), serum creatinine (P=0.004), blood brain natriuretic peptide (P=0.005) pericatheter use. The most common pathogens were Gram-negative bacteria, especially Acinetobacter baumannii, which caused 37.5% CRBSI and 20.0% CRCOL. Multivariate Cox regression model showed female (P=0.029, HR=2.151), diabetes (P=0.016, HR=2.807), receive catecholamine inotropes therapy (P=0.012, HR=2.655), immunosuppression (P=0.037, HR=2.203) were independent risk factors associated with catheter-related infection.
ConclusionsThe incidence of CRBSI and CRCOL is 3.565 and 2.228 events per 1000 catheter-days CRRT patients in our hospital. The most common pathogen of catherter-related infection is Gram-negative bacteria. Female, diabetes, received catecholamine inotropic drugs, and immunosuppression were independent risk factors associated with catheter-related infection.
Key words:
Renal replacement therapy; Central venous catheter; Catheter-related infection; Risk factors; Pathogen
Contributor Information
Xiaotian Liu
Department of Nephrology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
Key Laboratory of Nephrology, Ministry of Health, Guangzhou 510080, China
Hongjian Ye
Department of Nephrology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
Key Laboratory of Nephrology, Ministry of Health, Guangzhou 510080, China
Xunhua Zheng
Department of Nephrology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
Key Laboratory of Nephrology, Ministry of Health, Guangzhou 510080, China
Zhihua Zheng
Department of Nephrology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
Key Laboratory of Nephrology, Ministry of Health, Guangzhou 510080, China
Miaoqing Lu
Department of Nephrology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
Key Laboratory of Nephrology, Ministry of Health, Guangzhou 510080, China
Zhong Zhong
Department of Nephrology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
Key Laboratory of Nephrology, Ministry of Health, Guangzhou 510080, China
Cuifang Zhan
Department of Nephrology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
Key Laboratory of Nephrology, Ministry of Health, Guangzhou 510080, China
Suiqin Wen
Department of Nephrology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
Key Laboratory of Nephrology, Ministry of Health, Guangzhou 510080, China
Wei Chen
Department of Nephrology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
Key Laboratory of Nephrology, Ministry of Health, Guangzhou 510080, China
Xueqing Yu
Key Laboratory of Nephrology, Ministry of Health, Guangzhou 510080, China
Guangdong General Hospital, Guangzhou 510080, China