Microbial Repercussion on Hemodialysis Catheter-Related Bloodstream Infection Outcome: A 2-Year Retrospective Study

Figures & data

Table 1 Demographic Characteristics of the Study Participants

Parameters	Patients with CRBSI (n= 139)	Percentage (%)
Age in years (mean ± SD)	60.79 ± 11.45
Gender
Females	79	56.8%
Males	60	43.2%
Primary cause of ESRD
Diabetic nephropathy	63	45.3%
Chronic glomerulonephritis	24	17.3%
Lupus nephritis	19	13.7%
Obstructive uropathy	17	12.2%
Hypertension	16	11.5%
Associated comorbidities
CVD	24	17.3%
Hepatitis B	19	13.7%
HIV positivity	12	8.6%
ITP	9	6.5%
Cancer	8	5.8%
Hepatitis C	7	5.0%
Concomitant immunosuppressive therapy	28	20.1%

Abbreviations: CRBSI, catheter-related bloodstream infection; n, number; SD, standard deviation; ESRD, end-stage renal disease; CVD, cardiovascular disease; HIV, human immunodeficiency virus; ITP, immune thrombocytopenic purpura.

Table 2 Spectrum of the Pathogens Associated with CRBSI Among the Study Subjects

Organisms	Number of Isolates (n= 139)	Percentage (%)
Gram-positive organisms (Total)	97	69.8%
1. Coagulase-negative staphylococci (CoNS)	55	39.6%
Staphylococcus epidermidis	38	27.2%
Staphylococcus haemolyticus	4	2.9%
Staphylococcus hominis	4	2.9%
Staphylococcus capitis	3	2.2%
Staphylococcus saprophyticus	3	2.2%
Staphylococcus lugdunensis	3	2.2%
2. Staphylococcus aureus (Total)	42	30.2%
Gram-negative bacilli (Total)	42	30.2%
Klebsiella pneumoniae	15	10.8%
Pseudomonas aeruginosa	12	8.6%
Enterobacter cloacae	8	5.8%
Acinetobacter baumannii	7	5.0%

Table 3 Antibiotic Susceptibility Profiles of Gram-Negative Bacilli Causing CRBSIs

Antibiotics	K. pneumoniae n= 15 (%)	P. aeruginosa n= 12 (%)	E. cloacae n= 8 (%)	A. baumannii n= 7 (%)	Total n= 42 (%)
TGC	15 (100%)	NA	8 (100%)	6 (85.7%)	96.7%*
MEM	14 (93.3%)	10 (83.3%)	8 (100%)	6 (85.7%)	90.5%
TZP	15 (100%)	8 (66.7%)	8 (100%)	5 (71.4%)	85.7%
IPM	14 (93.3%)	8 (66.7%)	8 (100%)	5 (71.4%)	83.3%
AK	14 (93.3%)	8 (66.7%)	8 (100%)	5 (71.4%)	83.3%
CIP	12 (80%)	6 (50%)	6 (75%)	5 (71.4%)	69%
FEP	9 (60%)	4 (33.3%)	4 (50%)	4 (57.1%)	50%
SXT	9 (60%)	NA	3 (37.5%)	3 (43%)	50%*
CRO	7 (46.7%)	NA	2 (25%)	3 (43%)	40%*
ESBL-producers	7 (46.7%)	6 (50%)	3 (37.5%)	4 (57.1%)	47.6%
CR isolates	2 (13.3%)	4 (33.3%)	0	2 (28.6%)	8 (19%)
MDR isolates	2 (13.3%)	2 (16.7%)	1 (12.5%)	2 (28.6%)	16.7%

Note: *Percentages were calculated in relation to 30 isolates only.

Abbreviations: K. pneumoniae, Klebsiella pneumoniae; P. aeruginosa, Pseudomonas aeruginosa; E. cloacae, Enterobacter cloacae; A. baumannii, Acinetobacter baumannii; n, number; NA, not applicable; TGC, tigecycline; MEM, meropenem; TPZ, piperacillin/tazobactam; IPM, imipenem; AK, amikacin; CIP, ciprofloxacin; FEP, cefepime; SXT, trimethoprim/sulfamethoxazole; CRO, ceftriaxone; ESBL, extended spectrum β-lactamase; CR, carbapenem-resistant; MDR, multidrug-resistant.

Table 4 Primary Clinical Presentations and Complications of CRBSIs in Relation to the Causative Organism

Parameters	S. aureus (n= 42)	CoNS (n= 55)	GNB (n= 42)	χ^2	p value
Primary clinical presentations
Fever	29 (20.9%)	18 (12.9%)	9 (6.5%)	21.95	0.0001*
Rigors	5 (3.6%)	27 (19.4%)	10 (7.2%)	16.78	0.0001*
Vomiting	4 (2.9%)	5 (3.6%)	12 (8.6%)	8.51	0.014*
Hypotension	4 (2.9%)	5 (3.6%)	11 (7.9%)	6.81	0.033*
Complications of CRBSI
Hospitalization	5 (11.9%)	5 (9.1%)	12 (28.6%)	91.19	0.0001*
Endocarditis	7 (16.7%)	8 (14.5%)	1 (2.4%)	57.23	0.0001*
ICU Admission	1 (2.4%)	2 (3.6%)	11 (26.2%)	66.35	0.0001*
Septic embolism	6 (14.3%)	2 (3.6%)	0 (0.0%)	92.69	0.0001*

Notes: *p < 0.05. Frequencies of the clinical presentations were calculated in relation to the total number of the isolates (n= 139).

Abbreviations: S. aureus, Staphylococcus aureus; CoNS, Coagulase-negative staphylococci; GNB, Gram-negative bacilli; n, number; ICU, intensive care unit; χ², Pearsons Chi-Square test.