Journal article
A prospective study of hemodialysis access-related bacterial infections


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Publication Details
Author list: Ibrahiem Saeed Abdulrahman, Samir H. Al-Mueilo, Huda A. Bokhary, Gani O. A. Ladipo and Abdulla Al-Rubaish
Publisher: Elsevier
Publication year: 2002
Journal: Journal of Infection and Chemotherapy
Journal name in source: Journal of Infection and Chemotherapy
Volume number: 8
Issue number: 3
Start page: 242
End page: 246
Number of pages: 5
ISSN: 1341-321X
Web of Science ID:
PubMed ID: 12373488
Scopus ID: 0036745633
eISSN: 1437-7780


The objective of this study was to describe hemodialysis
vascular-access related infections that occurred in
hemodialysis patients over an 18-month period. The study
is a prospective descriptive analysis of incidence infection
rates in a hemodialysis unit in a tertiary-care medical center.
Prospective surveillance for hemodialysis vascular accessrelated
infection was performed for all patients undergoing
hemodialysis from November 1999 through April 2001 at
King Fahd Hospital of King Faisal University, Al-Khobar,
Saudi Arabia. The total number of dialysis sessions was
calculated. The type of vascular access was noted. Cultures
were obtained and all infections were recorded and infection
rates were calculated. There were 9627 hemodialysis
sessions (5437 via permanent fistulae or grafts, 2409 via
temporary central catheters, and 1781 via permanent tunneled
catheters) during the 18-month study period. We
identified a total of 109 infections, for a rate of 11.32/1000
dialysis sessions (ds). Of the 109, 23 involved permanent
fistulae or grafts (4.23/1000ds); 18 involved permanenttunneled
central catheter infections (10.1/1000ds); and 68
involved temporary-catheter infections (28.23/1000ds).
There were 38 bloodstream infections (3.95/1000ds) and 34
episodes of clinical sepsis (3.53/1000ds). Seventy-one vascular
access infections without bacteremia were identified
(7.38/1000ds), including 16 permanent-fistulae or graft infections
(2.94/1000ds), 7 permanent-tunneled central catheter
infections (3.93/1000ds), and 48 temporary-catheter
infections (19.92/1000ds). Staphylococcal organisms were
responsible for 77% of the infections, with Staphylococcus
epidermidis being the strain most commonly implicated.
Gram-negative organisms were responsible for 23% of the
infections. In conclusion, infection rates were highest in
hemodialysis patients with temporary vascular access, compared
with rates in those with permanent arteriovenous
fistulae and synthetic grafts. Most of the bacterial organisms
isolated from the vascular access sites were gram-positive
cocci, with S. epidermidis accounting for 50% of the organisms.
The rate of infection with gram-negative bacilli was
higher than in other reports. Our greater dependence on
central venous catheters, due to local factors, coupled
with the immune-compromising comorbid conditions of our
patients, may be contributory to the pattern of infection
reported. Delays in the creation of vascular grafts for
hemodialysis access should be avoided.


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Last updated on 2020-25-11 at 08:59