Prevention and management of catheter-related infection in hemodialysis patients

被引:165
作者
Lok, Charmaine E. [1 ,2 ]
Mokrzycki, Michele H. [3 ,4 ]
机构
[1] Toronto Gen Hosp, Dept Med, Div Nephrol, Toronto, ON M5G 2C4, Canada
[2] Univ Toronto, Toronto, ON, Canada
[3] Montefiore Med Ctr, Dept Med, Div Nephrol, Bronx, NY 10467 USA
[4] Albert Einstein Coll Med, Bronx, NY 10467 USA
关键词
hemodialysis access; sepsis; slime and virulence factors; Staphylococcus aureus; vascular access; CENTRAL VENOUS CATHETER; BLOOD-STREAM INFECTION; RESISTANT STAPHYLOCOCCUS-AUREUS; STERILE BARRIER PRECAUTIONS; VASCULAR ACCESS INFECTIONS; ANTIBIOTIC-LOCK; BIOFILM FORMATION; POVIDONE-IODINE; TRISODIUM CITRATE; METHICILLIN-RESISTANT;
D O I
10.1038/ki.2010.471
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Central venous catheter-related infections have been associated with high morbidity, mortality, and costs. Catheter use in chronic hemodialysis patients has been recognized as distinct from other patient populations who require central venous access, leading to recent adaptations in guidelines-recommended diagnosis for catheter-related bacteremia (CRB). This review will discuss the epidemiology and pathogenesis of hemodialysis CRB, in addition to a focus on interventions that have favorably affected CRB outcomes. These include: (1) the use of prophylactic topical antimicrobial ointments at the catheter exit site, (2) the use of prophylactic catheter locking solutions for the prevention of CRB, (3) strategies for management of the catheter in CRB, and (4) the use of vascular access managers and quality initiative programs. Kidney International (2011) 79, 587-598; doi: 10.1038/ki.2010.471; published online 22 December 2010
引用
收藏
页码:587 / 598
页数:12
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