Abstract:
OBJECTIVE To investigate the epidemiological characteristics of infections in hemodialysis patients so as to provide bases for prevention and control of the infections in the hemodialysis patients.
METHODS The patients who underwent maintenance hemodialysis in blood purification rooms of the Fifth Affiliated Hospital of Zhengzhou University in the first two working days each month from 2018 to 2022 were recruited as the research subjects. The incidence of hemodialysis-related events among the hemodialysis patients, including intravenous use of antibiotics, positive blood culture, exacerbation of pus, redness or swellings emerging at vascular access sites, were prospectively investigated.
RESULTS A total of 386 case-times of hemodialysis-related events were monitored in 2018-2022, including 20 case-times of bloodstream infections, 354 case-times of intravenous use of antibiotics and 12 case-times of exacerbation of pus, redness or swellings emerging at vascular access sites. The incidence of hemodialysis-induced events was 4.19 per 100 patients each month, the average incidence rate of bloodstream infections was 0.22 per 100 patients each month. The patients with tunneled central venous catheter were 40.69 times the risk of bloodstream infections as the patients with intestinal fistula (95%CI: 9.725~361.703, P < 0.001). The incidence of bloodstream infections was decreased by 53.85% among the hemodialysis patients in 2022 as compared with that in 2018. Staphylococcus aureus was the predominant species of pathogens causing the bloodstream infections.
CONCLUSIONS The hemodialysis patients are the population at high risk of infections. The incidence of bloodstream infections and other infections is higher among the patients with tunneled central venous catheters than among the patients with other types of vascular accesses. The monitoring of hemodialysis-related infection events may reduce the incidence of bloodstream infections.