A retrospective study of tunnelled haemodialysis central line-associated bloodstream infections

Abstract

Infection is a serious complication of tunnelled haemodialysis catheters. We aimed to describe the epidemiology of tunnelled haemodialysis central line-associated bloodstream infections (CLABSI) in an Australian centre. We performed a retrospective audit of tunnelled haemodialysis CLABSI from June 2010 to June 2014. From 674 catheter insertions, 70 CLABSI occurred in 55 patients at a rate of 0.95 infections per 1000 catheter days. Aboriginal and Torres Strait Islanders (ATSI) compared to non-ATSI had a higher rate of CLABSI (1.70 vs 0.58 CLABSI per 1000 catheter days, p < 0.001). Staphylococcus aureus (n = 22, 31.4%), coagulase negative Staphylococci (n = 14, 17.5%), and Gram negative bacilli (n = 28, 35.0%) were the predominant causative organisms. Two patients who died both had Staphylococcus aureus infection. In conclusion, our infection rate and microbiology are similar to prior reports. Morbidity and mortality are associated with Staphylococcus aureus as the causative organism.

Keywords:

• CLABSI
• central line associated bacteremia
• central line associated bloodstream infection
• haemodialysis catheter
• tunnelled catheter
• antibiotic lock

Additional information

Notes on contributors

Anoushka Krishnan

Anoushka Krishnan is a nephrology fellow who performed this work at Royal Perth Hospital.

Khushnam Irani

Khushnam Irani is an internal medicine trainee who performed this work at Royal Perth Hospital.

Ramyasuda Swaminathan

Ramyasuda Swaminathan is a transplant nephrologist at Fiona Stanley Hospital.

Peter Boan

Peter Boan is an infectious diseases physician and microbiologist at Fiona Stanley Hospital and PathWest Laboratory Medicine WA, specialising in the management of transplant and other immunocompromised patients.