Usefulness of endoluminal catheter colonization surveillance cultures to reduce catheter-related bloodstream infections in hemodialysis

摘要: Background: To evaluate the use of surveillance cultures (SCs) to prevent catheter-related bloodstream infections (CRBSIs) in asymptomatic hemodialysis (HD) patients. Methods: In 2011-2012, we conducted a prospective study HD patients with tunneled cuffed central venous catheters (TCCs). Colonization catheter lumen was assessed every 15 days by inoculating w5 mL endoluminal blood into aerobic culture bottles. Individual were triaged based on SC results: group 1 (negative); 2 (coagulase-negative Staphylococcus [CoNS] time-to-positivity (TTP) >14 hours); 3 (CoNS TTP � 14 and 4 (any microorganism other than CoNS any TTP). Results: We studied 104 (129 TCCs). Median follow-up 262.5 (interquartile range [IR], 135.0-365.0). A total 1,734 SCs collected (median, 18 per patient; IR, 10.0-24.0), which 1,634 (94.2%) negative (group 1) 100 (5.8%) positive 2: 79; 3: 12, 4: 9). groups 3, 19 TCCs required antibiotic lock therapy (ALT). 4, all received intravenous ALT. Under this protocol, there 0.27 episodes CRBSI 1,000 compared 1.65 (P < .001) prior its implementation. Conclusion: easily accessible samples proved useful triaging at high risk infection.