Targeted surveillance of vascular access infection in hemodialysis outpatients

Abstract:

ObjectiveTo investigate the occurrence and risk factors of vascular access infection(VAI) in hemodialysis outpatients. MethodsProspective surveillance method, monitoring methods was formulated and adopted by referring to the relevant guidelines and regulations at home and abroad, targeted surveillance was performed among all outpatients receiving hemodialysis in a hospital from June 1, 2014 to May 31, 2016. ResultsA total of 584 outpatients received hemodialysis from June 1, 2014 to May 31, 2016, with 64 203 times of vascular access, 79 patients developed 85 cases of infection, case incidence of VAI was 1.32‰. 36 cases（42.35%） were infection at vascular puncture sites, 49 (57.65%） were vascular accessrelated bloodstream infection. Among patients with different types of vascular access, incidence of VAI was the highest among patients with artificial vascular graft（19.67‰），followed by those with nontunneled central venous catheter（4.91‰）, with tunneled central venous catheter（0.73‰）, and with arteriovenous fistula（0.09‰）. Age＞60 years, hemodialysis time>1 year, diabetes, and hypertension were risk factors for VAI in outpatients with hemodialysis(all P<0.05). 39 strains of pathogens were isolated from 49 patients with vascular accessrelated bloodstream infection, including 36 (92.31%) grampositive bacteria, mainly Staphylococcus aureus(n=30, 6 of which were methicillinresistant Staphylococcus aureus); 3(7.69%) gramnegative bacteria. ConclusionStrengthening prospective targeted surveillance can better understand the status, characteristics, and risk factors of VAI in hemodialysis outpatients, it is conducive to taking targeted prevention and control measures, thus reduce the incidence of VAI in hemodialysis outpatients.