Bacteremia associated with tunneled hemodialysis catheters: outcome after attempted salvage

Damien R Ashby, Albert Power, Seema Singh, Peter Choi, David H Taube, Neill D Duncan, Tom D Cairns

Research output: Contribution to journalArticle (Academic Journal)peer-review

47 Citations (Scopus)

Abstract

BACKGROUND AND OBJECTIVES: Treatment without catheter replacement (catheter salvage) has been described for bacteremia associated with tunneled venous catheters in hemodialysis patients, but few data are available on which to base an estimation of the likelihood of treatment success.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In a prospective cohort study, all cases of catheter-associated bacteremia that occurred in a large dialysis center were identified during a 12-mo period. Catheter salvage was attempted according to a standard protocol in all cases in which a favorable early response to antibiotic therapy was seen, and patients were followed for at least 6 mo. Bacteremias, catheter changes, and all major clinical events were recorded.

RESULTS: During a period covering 252,986 catheter days, 208 episodes were identified involving 133 patients, 74% of which were selected for attempted salvage. Salvage was successful in 66.1% of incident bacteremias with a very low complication risk (0.9%). Some bacteremias, however, recurred as late as 6 mo after the initial infection; salvage was less likely to be successful in treating recurrences.

CONCLUSIONS: Appropriately used catheter salvage can be successful in approximately two thirds of cases; however, recurrences continue to occur up to 6 mo later and are unlikely to be cured without catheter replacement.

Original languageEnglish
Pages (from-to)1601-5
Number of pages5
JournalClinical Journal of the American Society of Nephrology
Volume4
Issue number10
DOIs
Publication statusPublished - Oct 2009

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Bacteremia
  • Catheter-Related Infections
  • Cohort Studies
  • Humans
  • Middle Aged
  • Prospective Studies
  • Recurrence
  • Renal Dialysis
  • Treatment Outcome

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