Bacteremia in hemodialysis and peritoneal dialysis patients

I. Kuan Wang, Yi Chih Chang, Chih Chia Liang, Feng Rong Chuang, Chiz Tzung Chang, Hsin Hung Lin, Chung Chih Lin, Tzung Hai Yen, Po Chang Lin, Che Yi Chou, Chiu Ching Huang, Wen Chen Tsai, Jin Hua Chen

Research output: Contribution to journalArticle

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Abstract

Objective To analyze the incidence rates and risk factors for bacteremia in patients undergoing hemodialysis (HD) and peritoneal dialysis (PD). Methods The records of 898 consecutive patients undergoing dialysis from January 2003 to December 2008 were reviewed retrospectively. Episodes of bacteremia were recorded. China Medical University (Taichung, Taiwan). Results The overall incidence rate of bacteremia was 7.63 per 100 patient-years in HD patients and 3.56 per 100 patient-years in PD patients and it was higher in HD patients each year from 2003 to 2008. S. aureus (27.53%) was the most common pathogen in HD patients, whereas Coagulase-negative Staphylococcus (21.3%) was the most common pathogen in PD patients. Vascular access infection was the most common etiology in HD patients, whereas peritonitis was the most common etiology in PD patients. Older age, shorter dialysis vintage, use of HD rather than PD, current smoker, use of a venous dialysis catheter, presence of diabetes mellitus, higher comorbidity score, and lower serum albumin were significant risk factors for bacteremia. Diabetes mellitus and lower serum albumin were significant risk factors for bacteremia-associated mortality. Conclusion Placement of a permanent access (fistula, graft, or PD catheter) prior to initiation of dialysis, smoking cessation, and better nutritional status (i.e. higher serum albumin) were associated with a reduced risk of bacteremia in dialysis patients. Higher serum albumin was also associated with a reduced bacteremiaassociated mortality.

Original languageEnglish
Pages (from-to)1015-1021
Number of pages7
JournalInternal Medicine
Volume51
Issue number9
DOIs
Publication statusPublished - 2012
Externally publishedYes

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Peritoneal Dialysis
Bacteremia
Renal Dialysis
Dialysis
Serum Albumin
Diabetes Mellitus
Catheters
Mortality
Coagulase
Incidence
Smoking Cessation
Peritonitis
Nutritional Status
Taiwan
Staphylococcus
Fistula
Blood Vessels
Comorbidity
China
Transplants

Keywords

  • Bacteremia
  • Dialysis
  • End-stage renal disease
  • Incidence rate
  • Mortality

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Wang, I. K., Chang, Y. C., Liang, C. C., Chuang, F. R., Chang, C. T., Lin, H. H., ... Chen, J. H. (2012). Bacteremia in hemodialysis and peritoneal dialysis patients. Internal Medicine, 51(9), 1015-1021. https://doi.org/10.2169/internalmedicine.51.7111

Bacteremia in hemodialysis and peritoneal dialysis patients. / Wang, I. Kuan; Chang, Yi Chih; Liang, Chih Chia; Chuang, Feng Rong; Chang, Chiz Tzung; Lin, Hsin Hung; Lin, Chung Chih; Yen, Tzung Hai; Lin, Po Chang; Chou, Che Yi; Huang, Chiu Ching; Tsai, Wen Chen; Chen, Jin Hua.

In: Internal Medicine, Vol. 51, No. 9, 2012, p. 1015-1021.

Research output: Contribution to journalArticle

Wang, IK, Chang, YC, Liang, CC, Chuang, FR, Chang, CT, Lin, HH, Lin, CC, Yen, TH, Lin, PC, Chou, CY, Huang, CC, Tsai, WC & Chen, JH 2012, 'Bacteremia in hemodialysis and peritoneal dialysis patients', Internal Medicine, vol. 51, no. 9, pp. 1015-1021. https://doi.org/10.2169/internalmedicine.51.7111
Wang IK, Chang YC, Liang CC, Chuang FR, Chang CT, Lin HH et al. Bacteremia in hemodialysis and peritoneal dialysis patients. Internal Medicine. 2012;51(9):1015-1021. https://doi.org/10.2169/internalmedicine.51.7111
Wang, I. Kuan ; Chang, Yi Chih ; Liang, Chih Chia ; Chuang, Feng Rong ; Chang, Chiz Tzung ; Lin, Hsin Hung ; Lin, Chung Chih ; Yen, Tzung Hai ; Lin, Po Chang ; Chou, Che Yi ; Huang, Chiu Ching ; Tsai, Wen Chen ; Chen, Jin Hua. / Bacteremia in hemodialysis and peritoneal dialysis patients. In: Internal Medicine. 2012 ; Vol. 51, No. 9. pp. 1015-1021.
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abstract = "Objective To analyze the incidence rates and risk factors for bacteremia in patients undergoing hemodialysis (HD) and peritoneal dialysis (PD). Methods The records of 898 consecutive patients undergoing dialysis from January 2003 to December 2008 were reviewed retrospectively. Episodes of bacteremia were recorded. China Medical University (Taichung, Taiwan). Results The overall incidence rate of bacteremia was 7.63 per 100 patient-years in HD patients and 3.56 per 100 patient-years in PD patients and it was higher in HD patients each year from 2003 to 2008. S. aureus (27.53{\%}) was the most common pathogen in HD patients, whereas Coagulase-negative Staphylococcus (21.3{\%}) was the most common pathogen in PD patients. Vascular access infection was the most common etiology in HD patients, whereas peritonitis was the most common etiology in PD patients. Older age, shorter dialysis vintage, use of HD rather than PD, current smoker, use of a venous dialysis catheter, presence of diabetes mellitus, higher comorbidity score, and lower serum albumin were significant risk factors for bacteremia. Diabetes mellitus and lower serum albumin were significant risk factors for bacteremia-associated mortality. Conclusion Placement of a permanent access (fistula, graft, or PD catheter) prior to initiation of dialysis, smoking cessation, and better nutritional status (i.e. higher serum albumin) were associated with a reduced risk of bacteremia in dialysis patients. Higher serum albumin was also associated with a reduced bacteremiaassociated mortality.",
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AU - Chang, Chiz Tzung

AU - Lin, Hsin Hung

AU - Lin, Chung Chih

AU - Yen, Tzung Hai

AU - Lin, Po Chang

AU - Chou, Che Yi

AU - Huang, Chiu Ching

AU - Tsai, Wen Chen

AU - Chen, Jin Hua

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N2 - Objective To analyze the incidence rates and risk factors for bacteremia in patients undergoing hemodialysis (HD) and peritoneal dialysis (PD). Methods The records of 898 consecutive patients undergoing dialysis from January 2003 to December 2008 were reviewed retrospectively. Episodes of bacteremia were recorded. China Medical University (Taichung, Taiwan). Results The overall incidence rate of bacteremia was 7.63 per 100 patient-years in HD patients and 3.56 per 100 patient-years in PD patients and it was higher in HD patients each year from 2003 to 2008. S. aureus (27.53%) was the most common pathogen in HD patients, whereas Coagulase-negative Staphylococcus (21.3%) was the most common pathogen in PD patients. Vascular access infection was the most common etiology in HD patients, whereas peritonitis was the most common etiology in PD patients. Older age, shorter dialysis vintage, use of HD rather than PD, current smoker, use of a venous dialysis catheter, presence of diabetes mellitus, higher comorbidity score, and lower serum albumin were significant risk factors for bacteremia. Diabetes mellitus and lower serum albumin were significant risk factors for bacteremia-associated mortality. Conclusion Placement of a permanent access (fistula, graft, or PD catheter) prior to initiation of dialysis, smoking cessation, and better nutritional status (i.e. higher serum albumin) were associated with a reduced risk of bacteremia in dialysis patients. Higher serum albumin was also associated with a reduced bacteremiaassociated mortality.

AB - Objective To analyze the incidence rates and risk factors for bacteremia in patients undergoing hemodialysis (HD) and peritoneal dialysis (PD). Methods The records of 898 consecutive patients undergoing dialysis from January 2003 to December 2008 were reviewed retrospectively. Episodes of bacteremia were recorded. China Medical University (Taichung, Taiwan). Results The overall incidence rate of bacteremia was 7.63 per 100 patient-years in HD patients and 3.56 per 100 patient-years in PD patients and it was higher in HD patients each year from 2003 to 2008. S. aureus (27.53%) was the most common pathogen in HD patients, whereas Coagulase-negative Staphylococcus (21.3%) was the most common pathogen in PD patients. Vascular access infection was the most common etiology in HD patients, whereas peritonitis was the most common etiology in PD patients. Older age, shorter dialysis vintage, use of HD rather than PD, current smoker, use of a venous dialysis catheter, presence of diabetes mellitus, higher comorbidity score, and lower serum albumin were significant risk factors for bacteremia. Diabetes mellitus and lower serum albumin were significant risk factors for bacteremia-associated mortality. Conclusion Placement of a permanent access (fistula, graft, or PD catheter) prior to initiation of dialysis, smoking cessation, and better nutritional status (i.e. higher serum albumin) were associated with a reduced risk of bacteremia in dialysis patients. Higher serum albumin was also associated with a reduced bacteremiaassociated mortality.

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KW - End-stage renal disease

KW - Incidence rate

KW - Mortality

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