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Hemodialysis Catheter-Related Infections in the Pediatric Age Group. A Single Center Study

,

Abstract

BACKGROUND:
Central venous catheter is one of the modalities of hemodialysis access, which has many complications. The common complication of the use of central venous catheter (CVC) in hemodialysis is infection.
OBJECTIVE:
To study the rate, causative agents and associated risk factors of central venous catheter related infections in pediatric patients on hemodialysis in a single center study for better prevention of this complication.
PATIENTS & METHODS:
A single-center prospective study was conducted in Al- Zohoor hemodialysis center in Central Child Teaching hospital, Baghdad, Iraq during six months from 1st of July to 31th of December 2018. The files of all patients with central venous catheter of pediatric age group below 16 years old were studied. The micro-organisms that were isolated from the swab culture of central venous catheter and the blood cultures were identified and tested for antibiotic susceptibility by using the manual procedure which takes 48h.
RESULTS:
Thirty cases were included in the study. 19 cases were males and 11 cases were females. In males, 8 (42.1%) cases were diagnosed with central venous catheter- related infection (CVC-RI) exit site swab culture. In females, 3 (27.3%) cases were diagnosed with CVC-RI. Regarding age group, ages from 1-5 years were2 cases, only 1(50.0%) case was positive exit site swab, ages from 6-10 years were 15 cases, only 4 (26.7%) cases were positive, ages from 11-15 years were 13 cases, only 6 (46.2%) cases were positive exit site swab. Regarding sites of central venous catheter (CVC),                   in the Jugular site, the total number of cases was 24 cases, only 7 (29.2%) cases were positive exit site swab. In the femoral site, the total number of cases was 4 cases, only 2 (50%) cases were positive exit site swab, the subclavian were 2 cases, and were positive in 2(100%) cases.                     The organisms obtained from CVC-RI were (Pseudomonas, 16.7%, staph.aurus, 13.3%, pseudomonas & staph.aurus & mixed organisms, 3.3%). About the gender, blood culture was positive in (5.3%) in males, and in females (9.1%), p =0.685. The blood culture was positive only in the age group 6-10 years (13.3%), p =0.343. C-reactive protein was positive in (25%).
CONCLUSION:
Higher C- reactive protein (CRP) illustrated a significant association with positive blood culture in this study (P < 0.05). Pseudomonas and Staph.aurus were the most common pathogens in this study, and the ages between 6-10 years were more prone to infection than other ages.
 

Keywords

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Iraqi Postgraduate Medical Journal
Volume 22, Issue 1
January 2023
Page 9-15
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