Bacteremia in Hemodialysis and Peritoneal Dialysis Patients

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概要

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• Objective To analyze the incidence rates and risk factors for bacteremia in patients undergoing hemodialysis (HD) and peritoneal dialysis (PD). Methods The records of 898 consecutive patients undergoing dialysis from January 2003 to December 2008 were reviewed retrospectively. Episodes of bacteremia were recorded. China Medical University (Taichung, Taiwan). Results The overall incidence rate of bacteremia was 7.63 per 100 patient-years in HD patients and 3.56 per 100 patient-years in PD patients and it was higher in HD patients each year from 2003 to 2008. S. aureus (27.53%) was the most common pathogen in HD patients, whereas Coagulase-negative Staphylococcus (21.3%) was the most common pathogen in PD patients. Vascular access infection was the most common etiology in HD patients, whereas peritonitis was the most common etiology in PD patients. Older age, shorter dialysis vintage, use of HD rather than PD, current smoker, use of a venous dialysis catheter, presence of diabetes mellitus, higher comorbidity score, and lower serum albumin were significant risk factors for bacteremia. Diabetes mellitus and lower serum albumin were significant risk factors for bacteremia-associated mortality. Conclusion Placement of a permanent access (fistula, graft, or PD catheter) prior to initiation of dialysis, smoking cessation, and better nutritional status (i.e. higher serum albumin) were associated with a reduced risk of bacteremia in dialysis patients. Higher serum albumin was also associated with a reduced bacteremia-associated mortality.

著者

• Chang Yi-chih

  Department Of Medical Laboratory Science And Biotechnology China Medical University

• WANG I-Kuan

  Division of Nephrology, Chang Gung Memorial Hospital at Chiayi, Taiwan

• Chuang Feng-rong

  Division Of Nephrology Department Of Internal Medicine Kaohsiung Chang Gung Memorial Hospital And Chang Gung University College Of Medicine

• Liang Chih-Chia

  Division of Nephrology, China Medical University Hospital, Taiwan

• Wang I-Kuan

  Division of Nephrology, China Medical University Hospital, Taiwan

• Huang Chiu-Ching

  Division of Nephrology and Kidney Institute, Department of Internal Medicine, China Medical University Hospital

• Chen Jin-Hua

  Biostatistics Center and Graduate Institute of Biostatistics, China Medical University, Taiwan

• Chang Chiz-Tzung

  Division of Nephrology, China Medical University Hospital, Taiwan

• Lin Hsin-Hung

  Division of Nephrology, China Medical University Hospital, Taiwan

• Lin Chung-Chih

  Division of Nephrology, China Medical University Hospital, Taiwan

• Yen Tzung-Hai

  Division of Nephrology, Chang Gung Memorial Hospital-Taipei Medical Center, Chang Gung University College of Medicine, Taiwan

• Lin Po-Chang

  Division of Infection, China Medical University Hospital, Taiwan

• Chou Che-Yi

  Division of Nephrology, China Medical University Hospital, Taiwan

• Tsai Wen-Chen

  Department of Health Service Administration, China Medical University, Taiwan

• Chuang Feng-Rong

  Division of Nephrology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan

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