Vascular Access-Related Bloodstream Infections in First Nations, Community and Teaching Canadian Dialysis Units, and Other Centre-Level Predictors

被引：7

作者：

Lafrance, Jean-Philippe ^{[1
]}

Iqbal, Sameena ^{[2
]}

Lelorier, Jacques ^{[3
]}

Dasgupta, Kaberi

Ritchie, Judith ^{[4
]}

Ward, Linda ^{[5
]}

Benaroya, Samuel

Barre, Paul ^{[2
]}

Cantarovich, Marcelo ^{[6
]}

Ghannoum, Marc ^{[7
]}

Proulx, Normand ^{[8
]}

Vasilevsky, Murray ^{[2
]}

Rahme, Elham

机构：

[1] McGill Univ, Ctr Hlth, Div Clin Epidemiol, Dept Epidemiol Biostat & Occupat Hlth, Montreal, PQ H3A 1A1, Canada

[2] McGill Univ, Ctr Hlth, Div Nephrol, Montreal, PQ H3A 1A1, Canada

[3] Univ Montreal, Dept Med, Montreal, PQ H3C 3J7, Canada

[4] McGill Univ, Ctr Hlth, Dept Nursing Res, Montreal, PQ H3A 1A1, Canada

[5] McGill Univ, Ctr Hlth, Dept Nursing Med Miss, Montreal, PQ H3A 1A1, Canada

[6] McGill Univ, Ctr Hlth, Multiorgan Transplant Program, Dept Med, Montreal, PQ H3A 1A1, Canada

[7] Ctr Hosp, Serv Nephrol, Verdun, PQ, Canada

[8] Hop Hull, Serv Nephrol, Gatineau, PQ, Canada

来源：

NEPHRON CLINICAL PRACTICE | 2010年 / 114卷 / 03期

关键词：

Arteriovenous fistula; Catheter-related infections; Epidemiology; Hemodialysis; Vascular access; CATHETER-RELATED BACTEREMIA; STAPHYLOCOCCUS-AUREUS CARRIAGE; CONTROLLED-TRIAL; ORAL RIFAMPIN; HEMODIALYSIS; SURVEILLANCE; PREVENTION; RISK; MANAGEMENT; MUPIROCIN;

D O I：

10.1159/000262303

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：

Background/Aims: Vascular access-related bloodstream infection (BSI) is frequent among patients undergoing hemodialysis increasing their morbidity and mortality, but its occurrence across various dialysis centre types is not known. The aims of this study were to describe the incidence rates and assess the variability in BSI risk between dialysis centre types and other centre-level variables. Methods: We conducted a retrospective cohort study of 621 patients initiating hemodialysis in 7 Canadian dialysis centres. Cox regression models, where access type was continuously updated, were used to identify predictors of BSI occurrence. Results: During follow-up of the cohort (median age 68.1 years, 41.7% female, and 76.7% initiating with a central venous catheter, CVC), 73 patients had a BSI (rate: 0.21/1000 person-days). The BSI risk was not different in First Nation units (adjusted relative risk: 0.47, 95% confidence interval: 0.06-3.72) and teaching hospitals (1.33, 0.70-2.54) compared to community hospitals. No other centre-related variables were associated with the risk of BSI. Conclusion: We did not find differences in the BSI risk among dialysis unit types, or any other centre-related variables. The rates of BSI in our population were lower than those observed in other settings, but the high proportion of patients using CVCs is concerning. Copyright (C) 2009 S. Karger AG, Basel

引用

页码：C204 / C212

页数：9