Girndt M
Klinik für Innere Medizin II, Nephrologie, Rheumatologie, Endokrinologie, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle/Saale, Deutschland.
Nephrologe. 2020;15(5):321-331. doi: 10.1007/s11560-020-00447-1. Epub 2020 Jul 16.
Patients with chronic kidney diseases are particularly at risk of infections and must therefore be protected against the risks of infection in dialysis treatment. Viral hepatitis no longer plays a very prominent role in dialysis facilities because nosocomial transmission can be reliably avoided. Nowadays, patients colonized with multidrug-resistant bacteria, including methicillin-resistant (MRSA), multidrug-resistant gram-negative bacteria or vancomycin-resistant enterococci, are more common. Bloodstream infections, which particularly occur in dialysis via central venous catheters, are potentially very dangerous for patients. Regular surveillance and targeted interventions in the event of excessive infection numbers are necessary. The hygienic handling of dialysis fluids has now become established through decades of experience and is ensured through the use of quality management systems. The coronavirus crisis poses special challenges for dialysis centers.
慢性肾脏病患者尤其容易受到感染，因此在透析治疗中必须防范感染风险。病毒性肝炎在透析机构中已不再扮演非常突出的角色，因为可以可靠地避免医院内传播。如今，携带耐多药细菌的患者更为常见，包括耐甲氧西林金黄色葡萄球菌（MRSA）、耐多药革兰氏阴性菌或耐万古霉素肠球菌。血流感染尤其容易通过中心静脉导管在透析过程中发生，对患者来说可能非常危险。在感染数量过多的情况下，定期监测和有针对性的干预是必要的。通过数十年的经验，透析液的卫生处理现已确立，并通过质量管理体系予以确保。冠状病毒危机给透析中心带来了特殊挑战。
