Hemodialysis infection a deadly complication

Infections are a common cause of death in hemodialysis patients, felling 15% of them every year. Septicemia is the most common infectious cause of mortality in hemodialysis patients, causing 11% of all deaths annually, the Centers for Disease Control and Prevention reports.¹ Other key infection facts in this patient population include:

- Bacterial pathogens causing infection can be either exogenous (i.e., acquired from contaminated dialysis fluids or equipment) or endogenous (i.e., caused by invasion of bacteria present in or on the patient).

- Colonization with potentially pathogenic microorganisms, often unknown to staff members, is common in patients with frequent exposure to hospitals and other health care settings.

- Colonization most often occurs when microorganisms are transmitted from a colonized or infected source patient to another patient on the hands of health care workers who do not comply with infection control precautions.

- The primary risk factor for access infection is access type. Catheters have the highest risk for infection, grafts an intermediate risk, and native arteriovenous (AV) fistulas the lowest. Other potential risk factors for vascular access infections include:

• location of the access in the lower extremity;

• recent access surgery;

• trauma, hematoma, dermatitis, or scratching over the access site;

• poor patient hygiene;

• poor needle insertion technique;

• older age;

• diabetes;

• immunosuppression;

• iron overload.

Reference

1. Centers for Disease Control and Prevention. Recommendations for preventing transmission of infections among chronic hemodialysis patients. MMWR 2001; 50:1-43.