Bitunguramye Adam, Nkundimana Gerard, Aboubasha Ahmed M, Kabahizi Jules, Rutikanga William, Nshimiyimana Laetitia, Rafiki Michel G
Epidemiology, University of Delaware, Newark, USA.
Internal Medicine and Nephrology, King Faisal Hospital, Kigali, RWA.
Cureus. 2024 Sep 16;16(9):e69554. doi: 10.7759/cureus.69554. eCollection 2024 Sep.
Background Patients undergoing hemodialysis for End-Stage Renal Disease (ESRD) are at risk for Hemodialysis Catheter-Related Bloodstream Infections (CRBSIs). This study evaluates the incidence, risk factors, organism types, and outcomes of CRBSI in adult patients on maintenance hemodialysis at King Faisal Hospital, Rwanda. Methods This was a prospective cohort study of adult patients with end-stage renal disease undergoing hemodialysis via central venous hemodialysis catheters at King Faisal Hospital, Rwanda. Upon receiving the IRB approval, 81 eligible patients, women, and men aged between 19 and 74, were enrolled. Restricted Mean Survival Time (RMST) analysis evaluated the risk factors for CRBSI. The statistical significance was determined using p-values, with a cut-off of 0.05. Results The incidence of CRBSI was found to be 0.78 episodes per 1,000 catheter-days. Acute hemodialysis catheter type and anemia were associated with increased risk for CRBSI, with a P-value less than 0.05. In addition, all CRBSI cases were due to bacteria, with 52.63% gram-negative and 47.37% gram-positive. Out of 19 CRBSI events, nine cases (47.37%) required hospitalization with a median duration of seven days. Approximately half of the CRBSIs required catheter removal. No metastatic infection or death was noted. Conclusion The present study demonstrated that our hemodialysis unit has an incidence of 0.78 episodes per 1,000 catheter-days. Catheter type and anemia were significantly associated with CRBSI.
背景 终末期肾病（ESRD）患者接受血液透析时存在血液透析导管相关血流感染（CRBSIs）风险。本研究评估了卢旺达费萨尔国王医院接受维持性血液透析的成年患者中CRBSI的发生率、危险因素、病原体类型及转归。方法 这是一项对卢旺达费萨尔国王医院通过中心静脉血液透析导管进行血液透析的终末期肾病成年患者的前瞻性队列研究。获得机构审查委员会（IRB）批准后，纳入了81名符合条件的患者，年龄在19至74岁之间，有男有女。受限平均生存时间（RMST）分析评估了CRBSI的危险因素。使用p值确定统计学显著性，临界值为0.05。结果 发现CRBSI的发生率为每1000导管日0.78次发作。急性血液透析导管类型和贫血与CRBSI风险增加相关，P值小于0.05。此外，所有CRBSI病例均由细菌引起，革兰氏阴性菌占52.63%，革兰氏阳性菌占47.37%。在19例CRBSI事件中，9例（47.37%）需要住院，中位住院时间为7天。大约一半的CRBSI需要拔除导管。未观察到转移性感染或死亡。结论 本研究表明，我们的血液透析单元每1000导管日的发生率为0.78次发作。导管类型和贫血与CRBSI显著相关。
