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Prevalence of infections and antimicrobial use among hemodialysis outpatients: A prospective multicenter study

Seminars in Dialysis Mar 21, 2020

Wu YL, Zhang JJ, Li RJ, et al. - Researchers undertook a prospective multicenter study in Anhui, China, to determine the prevalence as well as characteristics of infections and antimicrobials use in hemodialysis outpatients. For this purpose, they used the dialysis event surveillance protocol created by the National Healthcare Safety Network. This analysis involved 41 dialysis centers with 7,393 outpatients. The most frequent type of vascular access was fistula (85.3%), followed by tunneled central line (12.7%), and non‐tunneled central line (1.2%). Overall 118 dialysis events were reported and the overall pooled events rate was 1.60 per 100 patient‐months. The rates of intravenous antimicrobial initiation, positive blood culture, and pus, redness, or increased swelling at the vascular access site were estimated to be 0.91, 0.23, and 0.46 per 100 patient‐months, respectively. Patients with a central line often had a higher prevalence of dialysis events, and a lower prevalence of the same was noted in patients with a fistula. Increased risk of dialysis events was observed in correlation with factors such as older age, female gender, and having a central line. Overall, based on the findings, it is justified to ensure regular monitoring and improvement strategies in the management of infections in hemodialysis outpatients.

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