Chapter 43
Infections in Hemodialysis Patients
Bourne L. Auguste,
Christopher T. Chan,
Bourne L. Auguste
Division of Nephrology, Sunnybrook Health Sciences Centre, Toronto, Canada
Search for more papers by this authorChristopher T. Chan
Division of Nephrology, Toronto General Hospital, Toronto, Canada
Search for more papers by this authorBourne L. Auguste,
Christopher T. Chan,
Bourne L. Auguste
Division of Nephrology, Sunnybrook Health Sciences Centre, Toronto, Canada
Search for more papers by this authorChristopher T. Chan
Division of Nephrology, Toronto General Hospital, Toronto, Canada
Search for more papers by this authorBook Editor(s):Jonathan C. Craig MBChB, DipCH, MMed(Clin Epi), PhD, FAHMS,
Donald A. Molony MD,
Giovanni F.M. Strippoli MD, PhD, MPH, MM (Epi),
Jonathan C. Craig MBChB, DipCH, MMed(Clin Epi), PhD, FAHMS
Matthew Flinders Distinguished Professor Vice President and Executive Dean
College of Medicine and Public Health, Flinders University, Adelaide, Australia
Search for more papers by this authorDonald A. Molony MD
Professor of Medicine Distinguished Teaching Professor of the University of Texas System
Division of Renal Diseases and Hypertension AND Center for Clinical Research and Evidence-based Medicine, McGovern Medical School University of Texas, Houston, TX, USA
Search for more papers by this authorGiovanni F.M. Strippoli MD, PhD, MPH, MM (Epi)
Professor of Nephrology Adjunct Professor of Epidemiology
Department of Emergency and Organ Transplantation – University of Bari, Bari, Italy
School of Public Health, University of Sydney, Sydney, NSW, Australia
Search for more papers by this authorFirst published: 18 November 2022
Summary
Infections are the second leading cause of death after cardiovascular disease among hemodialysis (HD) patients and are on the rise. This chapter describes the detail risk factors for vascular and nonvascular infections in HD patients. It also discusses the current evidence for prevention and management of various infections. The chapter gives increasing resistance patterns of pathogenic microorganisms and highlights the risks of common nosocomial and bloodborne viral infections among HD patients. Few prognostic factors beyond immune system dysregulation in HD patients include the type and location of access site along with cannulation methods utilized. Hepatitis B virus maintains environmental stability by persisting on surfaces and equipment at ambient room temperatures, where it can remain infectious for up to 7 days after contamination. Patients on hemodialysis continue to be at an extremely high risk of contracting infections.
References
- Hill , N.R. , Fatoba , S.T. , Oke , J.L. et al. ( 2016 ). Global prevalence of chronic kidney disease – a systematic review and meta-analysis . PLoS ONE 11 ( 7 ): e0158765 .
- Thomas , B. , Wulf , S. , Bikbov , B. et al. ( 2015 ). Maintenance dialysis throughout the world in years 1990 and 2010 . J. Am. Soc. Nephrol. 26 ( 11 ): 2621 – 2633 .
- Chadban , S.J. , Briganti , E.M. , Kerr , P.G. et al. ( 2003 ). Prevalence of kidney damage in Australian adults: the AusDiab kidney study . J. Am. Soc. Nephrol. 14 ( 7 Suppl 2 ): S131 – S138 .
- Barberato , S.H. , Bucharles , S.G. , de Souza , A.M. et al. ( 2013 ). Association between inflammatory markers and left atrial enlargement in patients on hemodialysis . Arq. Bras. Cardiol. 100 ( 2 ): 141 – 146 .
- Ravani , P. , Palmer , S.C. , Oliver , M.J. et al. ( 2013 ). Associations between hemodialysis access type and clinical outcomes: a systematic review . J. Am. Soc. Nephrol. 24 ( 3 ): 465 – 473 .
- Eleftheriadis , T. , Liakopoulos , V. , Leivaditis , K. et al. ( 2011 ). Infections in hemodialysis: a concise review. Part I: Bacteremia and respiratory infections . Hippokratia 15 ( 1 ): 12 – 17 .
- Eleftheriadis , T. , Liakopoulos , V. , Leivaditis , K. et al. ( 2011 ). Infections in hemodialysis: a concise review. Part II: Blood transmitted viral infections . Hippokratia 15 ( 2 ): 120 – 126 .
- Bellomo , G. , Lippi , G. , Saronio , P. et al. ( 2003 ). Inflammation, infection and cardiovascular events in chronic hemodialysis patients: a prospective study . J. Nephrol. 16 ( 2 ): 245 – 251 .
- Agarwal , A.K. ( 2015 ). Systemic effects of hemodialysis access . Adv. Chronic. Kidney Dis. 22 ( 6 ): 459 – 465 .
- Collins , A.J. , Foley , R.N. , Herzog , C. et al. ( 2009 ). United States renal data system 2008 annual data report . Am. J. Kidney Dis. 53 ( 1 Suppl ): S1 – S374 .
- Collins , A.J. and Kliger , A.S. ( 2018 ). Urgent: stop preventable infections now . Clin. J. Am. Soc. Nephrol. 13 ( 4 ): 663 – 665 .
- Wong , L.P. ( 2018 ). Systems thinking and leadership: how nephrologists can transform dialysis safety to prevent infections . Clin. J. Am. Soc. Nephrol. 13 ( 4 ): 655 – 662 .
- Viecelli , A.K. , Tong , A. , O'Lone , E. et al. ( 2018 ). Report of the standardized outcomes in nephrology-hemodialysis (SONG-HD) consensus workshop on establishing a Core outcome measure for hemodialysis vascular access . Am. J. Kidney Dis. 71 ( 5 ): 690 – 700 .
- Viecelli , A.K. , O'Lone , E. , Sautenet , B. et al. ( 2018 ). Vascular access outcomes reported in maintenance hemodialysis trials: a systematic review . Am. J. Kidney Dis. 71 ( 3 ): 382 – 391 .
- Methods USRDSA ( 2012 ). In: USRDS 2012 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States . National Institutes of Health . Bethesda, MD . The United States Renal Data System. Chapter 3: Hospitalization and Mortality.
- Lok , C.E. and Foley , R. ( 2013 ). Vascular access morbidity and mortality: trends of the last decade . Clin. J. Am. Soc. Nephrol. 8 ( 7 ): 1213 – 1219 .
- Mendelssohn , D.C. , Ethier , J. , Elder , S.J. et al. ( 2006 ). Haemodialysis vascular access problems in Canada: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS II) . Nephrol. Dial. Transplant. 21 ( 3 ): 721 – 728 .
- System USRD ( 2012 ). International comparisons . In: USRDS 2012 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States . National Institutes of Health , Bethesda, MD : National Institute of Diabetes and Digestive and Kidney Diseases. The United States Renal Data System.Chapter 11: International Comparisons.
- Berns , J.S. ( 2003 ). Infection with antimicrobial-resistant microorganisms in dialysis patients . Semin. Dial. 16 ( 1 ): 30 – 37 .
- Berns , J.S. and Tokars , J.I. ( 2002 ). Preventing bacterial infections and antimicrobial resistance in dialysis patients . Am. J. Kidney Dis. 40 ( 5 ): 886 – 898 .
- D'Agata , E.M.C. ( 2018 ). Addressing the problem of multidrug-resistant organisms in dialysis . Clin. J. Am. Soc. Nephrol. 13 ( 4 ): 666 – 668 .
- Marston , H.D. , Dixon , D.M. , Knisely , J.M. et al. ( 2016 ). Antimicrobial resistance . JAMA 316 ( 11 ): 1193 – 1204 .
- Krishnasami , Z. , Carlton , D. , Bimbo , L. et al. ( 2002 ). Management of hemodialysis catheter-related bacteremia with an adjunctive antibiotic lock solution . Kidney Int. 61 ( 3 ): 1136 – 1142 .
- Mermel , L.A. , Farr , B.M. , Sherertz , R.J. et al. ( 2001 ). Guidelines for the management of intravascular catheter-related infections . J. Intraven. Nurs. 24 ( 3 ): 180 – 205 .
- Messing , B. , Peitra-Cohen , S. , Debure , A. et al. ( 1988 ). Antibiotic-lock technique: a new approach to optimal therapy for catheter-related sepsis in home-parenteral nutrition patients . J. Parenter. Enteral Nutr. 12 ( 2 ): 185 – 189 .
-
Miller , L.M.
,
Clark , E.
,
Dipchand , C.
et al. (
2016
).
Hemodialysis tunneled catheter-related infections
.
Can. J. Kidney Health Dis.
3
:
2054358116669129
.
10.1177/2054358116669129 Google Scholar
- Hoen , B. , Kessler , M. , Hestin , D. , and Mayeux , D. ( 1995 ). Risk factors for bacterial infections in chronic haemodialysis adult patients: a multicentre prospective survey . Nephrol. Dial. Transplant. 10 ( 3 ): 377 – 381 .
- Kessler , M. , Hoen , B. , Mayeux , D. et al. ( 1993 ). Bacteremia in patients on chronic hemodialysis. A multicenter prospective survey . Nephron 64 ( 1 ): 95 – 100 .
- Sarnak , M.J. and Jaber , B.L. ( 2000 ). Mortality caused by sepsis in patients with end-stage renal disease compared with the general population . Kidney Int. 58 ( 4 ): 1758 – 1764 .
- Allon , M. , Depner , T.A. , Radeva , M. et al. ( 2003 ). Impact of dialysis dose and membrane on infection-related hospitalization and death: results of the HEMO study . J. Am. Soc. Nephrol. 14 ( 7 ): 1863 – 1870 .
- Dalrymple , L.S. and Go , A.S. ( 2008 ). Epidemiology of acute infections among patients with chronic kidney disease . Clin. J. Am. Soc. Nephrol. 3 ( 5 ): 1487 – 1493 .
- Lee , H. , Manns , B. , Taub , K. et al. ( 2002 ). Cost analysis of ongoing care of patients with end-stage renal disease: the impact of dialysis modality and dialysis access . Am. J. Kidney Dis. 40 ( 3 ): 611 – 622 .
- Nissenson , A.R. , Dylan , M.L. , Griffiths , R.I. et al. ( 2005 ). Clinical and economic outcomes of Staphylococcus aureus septicemia in ESRD patients receiving hemodialysis . Am. J. Kidney Dis. 46 ( 2 ): 301 – 308 .
- Ramanathan , V. , Chiu , E.J. , Thomas , J.T. et al. ( 2007 ). Healthcare costs associated with hemodialysis catheter-related infections: a single-center experience . Infect. Control Hosp. Epidemiol. 28 ( 5 ): 606 – 609 .
- Chaiyakunapruk , N. , Veenstra , D.L. , Lipsky , B.A. , and Saint , S. ( 2002 ). Chlorhexidine compared with povidone-iodine solution for vascular catheter-site care: a meta-analysis . Ann. Intern. Med. 136 ( 11 ): 792 – 801 .
- Guo , H. , Liu , J. , Collins , A.J. , and Foley , R.N. ( 2008 ). Pneumonia in incident dialysis patients – the United States renal data system . Nephrol. Dial. Transplant. 23 ( 2 ): 680 – 686 .
- D'Agata , E.M. , Mount , D.B. , Thayer , V. , and Schaffner , W. ( 2000 ). Hospital-acquired infections among chronic hemodialysis patients . Am. J. Kidney Dis. 35 ( 6 ): 1083 – 1088 .
- Alexander , D. and Peacock , E. ( 1997 ). Drug resistant organisms and their implications for the outpatient dialysis setting . Nephrol. News Issues 11 ( 10 ): 27 – 28 , 30–21, 33–24.
- Crossley , K. , Loesch , D. , Landesman , B. et al. ( 1979 ). An outbreak of infections caused by strains of Staphylococcus aureus resistant to methicillin and aminoglycosides. I. Clinical studies . J. Infect. Dis. 139 ( 3 ): 273 – 279 .
- Groom , A.V. , Wolsey , D.H. , Naimi , T.S. et al. ( 2001 ). Community-acquired methicillin-resistant Staphylococcus aureus in a rural American Indian community . JAMA 286 ( 10 ): 1201 – 1205 .
- Ramphal , R. and Ambrose , P.G. ( 2006 ). Extended-spectrum beta-lactamases and clinical outcomes: current data . Clin. Infect. Dis. 42 ( Suppl 4 ): S164 – S172 .
- Evans , R. , Caskey , F. , Fluck , R. et al. ( 2016 ). UK Renal Registry 18th Annual Report: Epidemiology of reported infections amongst patients receiving dialysis for established renal failure in England 2013 to 2014 . A joint report from Public Health England and the UK Renal Registry . Nephron 132 ( Suppl 1 ): 279 – 288 .
- Mermel , L.A. ( 2011 ). What is the predominant source of intravascular catheter infections? Clin. Infect. Dis. 52 ( 2 ): 211 – 212 .
- Segura , M. , Llado , L. , Guirao , X. et al. ( 1993 ). A prospective study of a new protocol for 'in situ' diagnosis of central venous catheter related bacteraemia . Clin. Nutr. 12 ( 2 ): 103 – 107 .
- Safdar , N. and Maki , D.G. ( 2004 ). The pathogenesis of catheter-related bloodstream infection with noncuffed short-term central venous catheters . Intensive Care Med. 30 ( 1 ): 62 – 67 .
- Raad , I. , Costerton , W. , Sabharwal , U. et al. ( 1993 ). Ultrastructural analysis of indwelling vascular catheters: a quantitative relationship between luminal colonization and duration of placement . J. Infect. Dis. 168 ( 2 ): 400 – 407 .
- Jamal , M. , Ahmad , W. , Andleeb , S. et al. ( 2018 ). Bacterial biofilm and associated infections . J. Chin. Med. Assoc. 81 ( 1 ): 7 – 11 .
- Ramirez de Arellano , E. , Pascual , A. , Martinez-Martinez , L. , and Perea , E.J. ( 1994 ). Activity of eight antibacterial agents on Staphylococcus epidermidis attached to Teflon catheters . J. Med. Microbiol. 40 ( 1 ): 43 – 47 .
- Kropec , A. , Huebner , J. , Wursthorn , M. , and Daschner , F.D. ( 1993 ). in vitro activity of vancomycin and teicoplanin against Staphylococcus aureus and Staphylococcus epidermidis colonizing catheters . Eur. J. Clin. Microbiol. Infect. Dis. 12 ( 7 ): 545 – 548 .
- Gaillard , J.L. , Merlino , R. , Pajot , N. et al. ( 1990 ). Conventional and nonconventional modes of vancomycin administration to decontaminate the internal surface of catheters colonized with coagulase-negative staphylococci . J. Parenter. Enteral Nutr. 14 ( 6 ): 593 – 597 .
- Aslam , S. ( 2008 ). Effect of antibacterials on biofilms . Am. J. Infect. Control 36 ( 10 ): S175 . e179-111.
- Tsuchiya , K. , Yamaoka , K. , Tanaka , K. , and Sasaki , T. ( 2004 ). Bacterial spondylodiscitis in the patients with hemodialysis . Spine (Phila Pa 1976) 29 ( 22 ): 2533 – 2537 .
- Saad , T.F. ( 1999 ). Bacteremia associated with tunneled, cuffed hemodialysis catheters . Am. J. Kidney Dis. 34 ( 6 ): 1114 – 1124 .
- Nassar , G.M. , Fishbane , S. , and Ayus , J.C. ( 2002 ). Occult infection of old nonfunctioning arteriovenous grafts: a novel cause of erythropoietin resistance and chronic inflammation in hemodialysis patients . Kidney Int. Suppl. 80 : 49 – 54 .
- Marr , K.A. , Sexton , D.J. , Conlon , P.J. et al. ( 1997 ). Catheter-related bacteremia and outcome of attempted catheter salvage in patients undergoing hemodialysis . Ann. Intern. Med. 127 ( 4 ): 275 – 280 .
- Kovalik , E.C. , Raymond , J.R. , Albers , F.J. et al. ( 1996 ). A clustering of epidural abscesses in chronic hemodialysis patients: risks of salvaging access catheters in cases of infection . J. Am. Soc. Nephrol. 7 ( 10 ): 2264 – 2267 .
- Doulton , T. , Sabharwal , N. , Cairns , H.S. et al. ( 2003 ). Infective endocarditis in dialysis patients: new challenges and old . Kidney Int. 64 ( 2 ): 720 – 727 .
- McCarthy , J.T. and Steckelberg , J.M. ( 2000 ). Infective endocarditis in patients receiving long-term hemodialysis . Mayo Clin. Proc. 75 ( 10 ): 1008 – 1014 .
- Bhat , D.J. , Tellis , V.A. , Kohlberg , W.I. et al. ( 1980 ). Management of sepsis involving expanded polytetrafluoroethylene grafts for hemodialysis access . Surgery 87 ( 4 ): 445 – 450 .
- Ayus , J.C. and Sheikh-Hamad , D. ( 1998 ). Silent infection in clotted hemodialysis access grafts . J. Am. Soc. Nephrol. 9 ( 7 ): 1314 – 1317 .
- Engemann , J.J. , Friedman , J.Y. , Reed , S.D. et al. ( 2005 ). Clinical outcomes and costs due to Staphylococcus aureus bacteremia among patients receiving long-term hemodialysis . Infect. Control Hosp. Epidemiol. 26 ( 6 ): 534 – 539 .
- Sexton , D.J. ( 2001 ). Vascular access infections in patients undergoing dialysis with special emphasis on the role and treatment of Staphylococcus aureus . Infect. Dis. Clin. N. Am. 15 ( 3 ): 731 – 742 . vii.
- Benrashid , E. , Youngwirth , L.M. , Mureebe , L. , and Lawson , J.H. ( 2017 ). Operative and perioperative management of infected arteriovenous grafts . J. Vasc. Access 18 ( 1 ): 13 – 21 .
- Schild , A.F. , Simon , S. , Prieto , J. , and Raines , J. ( 2003 ). Single-center review of infections associated with 1,574 consecutive vascular access procedures . Vasc. Endovasc. Surg. 37 ( 1 ): 27 – 31 .
- Legout , L. , D'Elia , P.V. , Sarraz-Bournet , B. et al. ( 2012 ). Diagnosis and management of prosthetic vascular graft infections . Med. Mal. Infect. 42 ( 3 ): 102 – 109 .
- Quittnat Pelletier , F. , Joarder , M. , Poutanen , S.M. , and Lok , C.E. ( 2016 ). Evaluating approaches for the diagnosis of hemodialysis catheter-related bloodstream infections . Clin. J. Am. Soc. Nephrol. 11 ( 5 ): 847 – 854 .
- Dhingra , R.K. , Young , E.W. , Hulbert-Shearon , T.E. et al. ( 2001 ). Type of vascular access and mortality in US hemodialysis patients . Kidney Int. 60 ( 4 ): 1443 – 1451 .
- Saxena , A.K. and Panhotra , B.R. ( 2005 ). Haemodialysis catheter-related bloodstream infections: current treatment options and strategies for prevention . Swiss Med. Wkly. 135 ( 9–10 ): 127 – 138 .
- Oliver , M.J. , Callery , S.M. , Thorpe , K.E. et al. ( 2000 ). Risk of bacteremia from temporary hemodialysis catheters by site of insertion and duration of use: a prospective study . Kidney Int. 58 ( 6 ): 2543 – 2545 .
- Kairaitis , L.K. and Gottlieb , T. ( 1999 ). Outcome and complications of temporary haemodialysis catheters . Nephrol. Dial. Transplant. 14 ( 7 ): 1710 – 1714 .
- Wang , K. , Wang , P. , Liang , X. et al. ( 2015 ). Epidemiology of haemodialysis catheter complications: a survey of 865 dialysis patients from 14 haemodialysis centres in Henan province in China . BMJ Open 5 ( 11 ): e007136 .
- Ali , M.Z. and Goetz , M.B. ( 1997 ). A meta-analysis of the relative efficacy and toxicity of single daily dosing versus multiple daily dosing of aminoglycosides . Clin. Infect. Dis. 24 ( 5 ): 796 – 809 .
- Saxena , A.K. and Panhotra , B.R. ( 2005 ). Locking hemodialysis catheters with cefotaxime instead of gentamicin to avoid potential ototoxicity . Kidney Int. 67 ( 6 ): 2505 – 2506 .
- O'Grady , N.P. , Alexander , M. , Burns , L.A. et al. ( 2011 ). Guidelines for the prevention of intravascular catheter-related infections . Am. J. Infect. Control 39 ( 4 Suppl 1 ): S1 – S34 .
- Astor , B.C. , Eustace , J.A. , Powe , N.R. et al. ( 2005 ). Type of vascular access and survival among incident hemodialysis patients: the Choices for Healthy Outcomes in Caring for ESRD (CHOICE) Study . J. Am. Soc. Nephrol. 16 ( 5 ): 1449 – 1455 .
- Taylor , G. , Gravel , D. , Johnston , L. et al. ( 2002 ). Prospective surveillance for primary bloodstream infections occurring in Canadian hemodialysis units . Infect. Control Hosp. Epidemiol. 23 ( 12 ): 716 – 720 .
- Schutte , W.P. , Helmer , S.D. , Salazar , L. , and Smith , J.L. ( 2007 ). Surgical treatment of infected prosthetic dialysis arteriovenous grafts: total versus partial graft excision . Am. J. Surg. 193 ( 3 ): 385 – 388 . discussion 388.
- Aslam , S. , Vaida , F. , Ritter , M. , and Mehta , R.L. ( 2014 ). Systematic review and meta-analysis on management of hemodialysis catheter-related bacteremia . J. Am. Soc. Nephrol. 25 ( 12 ): 2927 – 2941 .
- Wong , B. , Muneer , M. , Wiebe , N. et al. ( 2014 ). Buttonhole versus rope-ladder cannulation of arteriovenous fistulas for hemodialysis: a systematic review . Am. J. Kidney Dis. 64 ( 6 ): 918 – 936 .
- Muir , C.A. , Kotwal , S.S. , Hawley , C.M. et al. ( 2014 ). Buttonhole cannulation and clinical outcomes in a home hemodialysis cohort and systematic review . Clin. J. Am. Soc. Nephrol. 9 ( 1 ): 110 – 119 .
- Ludlow , V. ( 2010 ). Buttonhole cannulation in hemodialysis: improved outcomes and increased expense – is it worth it? CANNT Journal 20 ( 1 ): 29 – 37 .
- MacRae , J.M. , Ahmed , S.B. , Atkar , R. , and Hemmelgarn , B.R. ( 2012 ). A randomized trial comparing buttonhole with rope ladder needling in conventional hemodialysis patients . Clin. J. Am. Soc. Nephrol. 7 ( 10 ): 1632 – 1638 .
- Vaux , E. , King , J. , Lloyd , S. et al. ( 2013 ). Effect of buttonhole cannulation with a polycarbonate PEG on in-center hemodialysis fistula outcomes: a randomized controlled trial . Am. J. Kidney Dis. 62 ( 1 ): 81 – 88 .
- Birchenough , E. , Moore , C. , Stevens , K. , and Stewart , S. ( 2010 ). Buttonhole cannulation in adult patients on hemodialysis: an increased risk of infection? Nephrol. Nurs. J. 37 ( 5 ): 491 – 498 , 555; quiz 499.
- Winkelmayer , W.C. , Owen , W.F. Jr. , Levin , R. , and Avorn , J. ( 2003 ). A propensity analysis of late versus early nephrologist referral and mortality on dialysis . J. Am. Soc. Nephrol. 14 ( 2 ): 486 – 492 .
- Innes , A. , Rowe , P.A. , Burden , R.P. , and Morgan , A.G. ( 1992 ). Early deaths on renal replacement therapy: the need for early nephrological referral . Nephrol. Dial. Transplant. 7 ( 6 ): 467 – 471 .
- Cortez , A.J. , Paulson , W.D. , and Schwab , S.J. ( 2005 ). Vascular access as a determinant of adequacy of dialysis . Semin. Nephrol. 25 ( 2 ): 96 – 101 .
- Saran , R. , Robinson , B. , Abbott , K.C. et al. ( 2018 ). US renal data system 2017 annual data report: epidemiology of kidney disease in the United States . Am. J. Kidney Dis. 71 ( 3S1 ): A7 .
- Collins , A.J. , Foley , R.N. , Herzog , C. et al. ( 2013 ). US renal data system 2012 annual data report . Am. J. Kidney Dis. 61 ( 1 Suppl 1 ): A7 . e1-476.
- Mermel , L.A. , Allon , M. , Bouza , E. et al. ( 2009 ). Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Diseases Society of America . Clin. Infect. Dis. 49 ( 1 ): 1 – 45 .
- Fogel , M.A. , Nussbaum , P.B. , Feintzeig , I.D. et al. ( 1998 ). Cefazolin in chronic hemodialysis patients: a safe, effective alternative to vancomycin . Am. J. Kidney Dis. 32 ( 3 ): 401 – 409 .
- Ryan , S.V. , Calligaro , K.D. , and Dougherty , M.J. ( 2004 ). Management of hemodialysis access infections . Semin. Vasc. Surg. 17 ( 1 ): 40 – 44 .
- Snaterse , M. , Ruger , W. , Scholte Op Reimer , W.J. , and Lucas , C. ( 2010 ). Antibiotic-based catheter lock solutions for prevention of catheter-related bloodstream infection: a systematic review of randomised controlled trials . J. Hosp. Infect. 75 ( 1 ): 1 – 11 .
- McCann , M. and Moore , Z.E. ( 2010 ). Interventions for preventing infectious complications in haemodialysis patients with central venous catheters . Cochrane Database Syst. Rev. 1 : CD006894.
- Jaffer , Y. , Selby , N.M. , Taal , M.W. et al. ( 2008 ). A meta-analysis of hemodialysis catheter locking solutions in the prevention of catheter-related infection . Am. J. Kidney Dis. 51 ( 2 ): 233 – 241 .
- Labriola , L. , Crott , R. , and Jadoul , M. ( 2008 ). Preventing haemodialysis catheter-related bacteraemia with an antimicrobial lock solution: a meta-analysis of prospective randomized trials . Nephrol. Dial. Transplant. 23 ( 5 ): 1666 – 1672 .
- Yahav , D. , Rozen-Zvi , B. , Gafter-Gvili , A. et al. ( 2008 ). Antimicrobial lock solutions for the prevention of infections associated with intravascular catheters in patients undergoing hemodialysis: systematic review and meta-analysis of randomized, controlled trials . Clin. Infect. Dis. 47 ( 1 ): 83 – 93 .
- Messing , B. , Man , F. , Colimon , R. et al. ( 1990 ). Antibiotic-lock technique is an effective treatment of bacterial catheter-related sepsis during parenteral nutrition . Clin. Nutr. 9 ( 4 ): 220 – 225 .
- El-Azizi , M. , Rao , S. , Kanchanapoom , T. , and Khardori , N. ( 2005 ). in vitro activity of vancomycin, quinupristin/dalfopristin, and linezolid against intact and disrupted biofilms of staphylococci . Ann. Clin. Microbiol. Antimicrob. 4 : 2 .
- Sabir , N. , Ikram , A. , Zaman , G. et al. ( 2017 ). Bacterial biofilm-based catheter-associated urinary tract infections: causative pathogens and antibiotic resistance . Am. J. Infect. Control 45 ( 10 ): 1101 – 1105 .
- Abbas , S.A. , Haloob , I.A. , Taylor , S.L. et al. ( 2009 ). Effect of antimicrobial locks for tunneled hemodialysis catheters on bloodstream infection and bacterial resistance: a quality improvement report . Am. J. Kidney Dis. 53 ( 3 ): 492 – 502 .
- Landry , D.L. , Braden , G.L. , Gobeille , S.L. et al. ( 2010 ). Emergence of gentamicin-resistant bacteremia in hemodialysis patients receiving gentamicin lock catheter prophylaxis . Clin. J. Am. Soc. Nephrol. 5 ( 10 ): 1799 – 1804 .
- Arechabala , M.C. , Catoni , M.I. , Claro , J.C. et al. ( 2018 ). Antimicrobial lock solutions for preventing catheter-related infections in haemodialysis . Cochrane Database Syst. Rev. 4 : CD010597.
- Hemmelgarn , B.R. , Moist , L.M. , Lok , C.E. et al. ( 2011 ). Prevention of dialysis catheter malfunction with recombinant tissue plasminogen activator . N. Engl. J. Med. 364 ( 4 ): 303 – 312 .
- Maki , D.G. , Ringer , M. , and Alvarado , C.J. ( 1991 ). Prospective randomised trial of povidone-iodine, alcohol, and chlorhexidine for prevention of infection associated with central venous and arterial catheters . Lancet 338 ( 8763 ): 339 – 343 .
- Onder , A.M. , Chandar , J. , Billings , A. et al. ( 2009 ). Chlorhexidine-based antiseptic solutions effectively reduce catheter-related bacteremia . Pediatr. Nephrol. 24 ( 9 ): 1741 – 1747 .
- Levin , A. , Mason , A.J. , Jindal , K.K. et al. ( 1991 ). Prevention of hemodialysis subclavian vein catheter infections by topical povidone-iodine . Kidney Int. 40 ( 5 ): 934 – 938 .
- Bassetti , S. , Hu , J. , D'Agostino , R.B. Jr. , and Sherertz , R.J. ( 2001 ). Prolonged antimicrobial activity of a catheter containing chlorhexidine-silver sulfadiazine extends protection against catheter infections in vivo . Antimicrob. Agents Chemother. 45 ( 5 ): 1535 – 1538 .
- Darouiche , R.O. , Raad , H.S.O. II et al. ( 1999 ). A comparison of two antimicrobial-impregnated central venous catheters. Catheter Study Group . N. Engl. J. Med. 340 ( 1 ): 1 – 8 .
- Hanna , H. , Benjamin , R. , Chatzinikolaou , I. et al. ( 2004 ). Long-term silicone central venous catheters impregnated with minocycline and rifampin decrease rates of catheter-related bloodstream infection in cancer patients: a prospective randomized clinical trial . J. Clin. Oncol. 22 ( 15 ): 3163 – 3171 .
- Hagau , N. , Studnicska , D. , Gavrus , R.L. et al. ( 2009 ). Central venous catheter colonization and catheter-related bloodstream infections in critically ill patients: a comparison between standard and silver-integrated catheters . Eur. J. Anaesthesiol. 26 ( 9 ): 752 – 758 .
- Garland , J.S. , Alex , C.P. , Mueller , C.D. et al. ( 2001 ). A randomized trial comparing povidone-iodine to a chlorhexidine gluconate-impregnated dressing for prevention of central venous catheter infections in neonates . Pediatrics 107 ( 6 ): 1431 – 1436 .
- Maki , D.G. , Stolz , S.M. , Wheeler , S. , and Mermel , L.A. ( 1997 ). Prevention of central venous catheter-related bloodstream infection by use of an antiseptic-impregnated catheter. A randomized, controlled trial . Ann. Intern. Med. 127 ( 4 ): 257 – 266 .
- Veenstra , D.L. , Saint , S. , and Sullivan , S.D. ( 1999 ). Cost-effectiveness of antiseptic-impregnated central venous catheters for the prevention of catheter-related bloodstream infection . JAMA 282 ( 6 ): 554 – 560 .
- Mermel , L.A. ( 2000 ). Prevention of intravascular catheter-related infections . Ann. Intern. Med. 132 ( 5 ): 391 – 402 .
- Rupp , M.E. , Lisco , S.J. , Lipsett , P.A. et al. ( 2005 ). Effect of a second-generation venous catheter impregnated with chlorhexidine and silver sulfadiazine on central catheter-related infections: a randomized, controlled trial . Ann. Intern. Med. 143 ( 8 ): 570 – 580 .
- Ostendorf , T. , Meinhold , A. , Harter , C. et al. ( 2005 ). Chlorhexidine and silver-sulfadiazine coated central venous catheters in haematological patients – a double-blind, randomised, prospective, controlled trial . Support Care Cancer 13 ( 12 ): 993 – 1000 .
- Brun-Buisson , C. , Doyon , F. , Sollet , J.P. et al. ( 2004 ). Prevention of intravascular catheter-related infection with newer chlorhexidine-silver sulfadiazine-coated catheters: a randomized controlled trial . Intensive Care Med. 30 ( 5 ): 837 – 843 .
- Weng , M. , Zhu , M. , Chen , W. , and Miao , C. ( 2014 ). Life-threatening anaphylactic shock due to chlorhexidine on the central venous catheter: a case series . Int. J. Clin. Exp. Med. 7 ( 12 ): 5930 – 5936 .
- Terazawa , E. , Shimonaka , H. , Nagase , K. et al. ( 1998 ). Severe anaphylactic reaction due to a chlorhexidine-impregnated central venous catheter . Anesthesiology 89 ( 5 ): 1296 – 1298 .
- Stephens , R. , Mythen , M. , Kallis , P. et al. ( 2001 ). Two episodes of life-threatening anaphylaxis in the same patient to a chlorhexidine-sulphadiazine-coated central venous catheter . Br. J. Anaesth. 87 ( 2 ): 306 – 308 .
- Jee , R. , Nel , L. , Gnanakumaran , G. et al. ( 2009 ). Four cases of anaphylaxis to chlorhexidine impregnated central venous catheters: a case cluster or the tip of the iceberg? Br. J. Anaesth. 103 ( 4 ): 614 – 615 .
- Raad , I. , Darouiche , R. , Dupuis , J. et al. ( 1997 ). Central venous catheters coated with minocycline and rifampin for the prevention of catheter-related colonization and bloodstream infections. A randomized, double-blind trial. The Texas Medical Center Catheter Study Group . Ann. Intern. Med. 127 ( 4 ): 267 – 274 .
- Sampath , L.A. , Tambe , S.M. , and Modak , S.M. ( 2001 ). in vitro and in vivo efficacy of catheters impregnated with antiseptics or antibiotics: evaluation of the risk of bacterial resistance to the antimicrobials in the catheters . Infect. Control Hosp. Epidemiol. 22 ( 10 ): 640 – 646 .
- Tambe , S.M. , Sampath , L. , and Modak , S.M. ( 2001 ). in vitro evaluation of the risk of developing bacterial resistance to antiseptics and antibiotics used in medical devices . J. Antimicrob. Chemother. 47 ( 5 ): 589 – 598 .
- Sychev , D. , Maya , I.D. , and Allon , M. ( 2011 ). Clinical management of dialysis catheter-related bacteremia with concurrent exit-site infection . Semin. Dial. 24 ( 2 ): 239 – 241 .
- Johnson , D.W. , MacGinley , R. , Kay , T.D. et al. ( 2002 ). A randomized controlled trial of topical exit site mupirocin application in patients with tunnelled, cuffed haemodialysis catheters . Nephrol. Dial. Transplant. 17 ( 10 ): 1802 – 1807 .
- Johnson , D.W. , van Eps , C. , Mudge , D.W. et al. ( 2005 ). Randomized, controlled trial of topical exit-site application of honey (Medihoney) versus mupirocin for the prevention of catheter-associated infections in hemodialysis patients . J. Am. Soc. Nephrol. 16 ( 5 ): 1456 – 1462 .
- Sesso , R. , Barbosa , D. , Leme , I.L. et al. ( 1998 ). Staphylococcus aureus prophylaxis in hemodialysis patients using central venous catheter: effect of mupirocin ointment . J. Am. Soc. Nephrol. 9 ( 6 ): 1085 – 1092 .
- Cheng , V.C. , Li , I.W. , Wu , A.K. et al. ( 2008 ). Effect of antibiotics on the bacterial load of meticillin-resistant Staphylococcus aureus colonisation in anterior nares . J. Hosp. Infect. 70 ( 1 ): 27 – 34 .
- Grothe , C. , Taminato , M. , Belasco , A. et al. ( 2014 ). Screening and treatment for Staphylococcus aureus in patients undergoing hemodialysis: a systematic review and meta-analysis . BMC Nephrol. 15 : 202 .
- Yoon , H.J. , Choi , J.Y. , Kim , C.O. et al. ( 2005 ). A comparison of clinical features and mortality among methicillin-resistant and methicillin-sensitive strains of Staphylococcus aureus endocarditis . Yonsei Med. J. 46 ( 4 ): 496 – 502 .
- Yu , V.L. , Goetz , A. , Wagener , M. et al. ( 1986 ). Staphylococcus aureus nasal carriage and infection in patients on hemodialysis. Efficacy of antibiotic prophylaxis . N. Engl. J. Med. 315 ( 2 ): 91 – 96 .
- European Best Practice Guidelines Expert Group on Hemodialysis ERA ( 2002 ). Section VI. Haemodialysis-associated infection . Nephrol. Dial. Transplant. 17 ( Suppl 7 ): 72 – 87 .
- Kluytmans , J. , van Belkum , A. , and Verbrugh , H. ( 1997 ). Nasal carriage of Staphylococcus aureus : epidemiology, underlying mechanisms, and associated risks . Clin. Microbiol. Rev. 10 ( 3 ): 505 – 520 .
- Amini , M. ( 2016 ). Evaluation the effectiveness of an educational intervention to decrease central line-associated bloodstream infections among hemodialysis patients . Am. J. Infect. Control 44 ( 12 ): 1703 – 1704 .
- Zhang , J. , Burr , R.A. , Sheth , H.S. , and Piraino , B. ( 2016 ). Organism-specific bacteremia by hemodialysis access . Clin. Nephrol. 86 ( 9 ): 141 – 146 .
- Eui Oh , S. , Lee , S.M. , Lee , Y.K. et al. ( 2013 ). Clostridium difficile -associated diarrhea in dialysis patients . Kidney Res. Clin. Pract. 32 ( 1 ): 27 – 31 .
- Kelly , C.P. , Pothoulakis , C. , and LaMont , J.T. ( 1994 ). Clostridium difficile colitis . N. Engl. J. Med. 330 ( 4 ): 257 – 262 .
- Centers for Disease Control ( 2012 ). Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine for adults with immunocompromising conditions: recommendations of the Advisory Committee on Immunization Practices (ACIP) . Morb. Mortal. Wkly. Rep. 61 ( 40 ): 816 – 819 .
- Inker , L.A. , Astor , B.C. , Fox , C.H. et al. ( 2014 ). KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD . Am. J. Kidney Dis. 63 ( 5 ): 713 – 735 .
- Cho , B.H. , Stoecker , C. , Link-Gelles , R. , and Moore , M.R. ( 2013 ). Cost-effectiveness of administering 13-valent pneumococcal conjugate vaccine in addition to 23-valent pneumococcal polysaccharide vaccine to adults with immunocompromising conditions . Vaccine 31 ( 50 ): 6011 – 6021 .
- KDIGO ( 2017 ). KDIGO 2017 clinical practice guideline on the prevention, diagnosis and treatment of hepatitis C in CKD . https://kdigo.org/clinical_practice_guidelines/Hep%20C/KDIGO%202017%20Hep%20C%20GL%20Public%20Review%20Draft%20FINAL.pdf (accessed 17 July 2018).
- Centers for Disease Control ( 2001 ). Recommendations for preventing transmission of infections among chronic hemodialysis patients . MMWR Recomm. Rep. 50 ( RR-5 ): 1 – 43 .
- Rebmann , T. and Barnes , S.A. ( 2011 ). Association for Professionals in Infection C, Epidemiology. Preventing infections in hemodialysis: an executive summary of the APIC Elimination Guide . Am. J. Infect. Control 39 ( 1 ): 72 – 75 .
- Finelli , L. , Miller , J.T. , Tokars , J.I. et al. ( 2005 ). National surveillance of dialysis-associated diseases in the United States, 2002 . Semin. Dial. 18 ( 1 ): 52 – 61 .
- Oguchi , H. , Miyasaka , M. , Tokunaga , S. et al. ( 1992 ). Hepatitis virus infection (HBV and HCV) in eleven Japanese hemodialysis units . Clin. Nephrol. 38 ( 1 ): 36 – 43 .
- Fehr , T. and Ambuhl , P.M. ( 2004 ). Chronic hepatitis virus infections in patients on renal replacement therapy . Nephrol. Dial. Transplant. 19 ( 5 ): 1049 – 1053 .
- Filippelli , M. , Lionetti , E. , Gennaro , A. et al. ( 2014 ). Hepatitis B vaccine by intradermal route in nonresponder patients: an update . World J. Gastroenterol. 20 ( 30 ): 10383 – 10394 .
- Barraclough , K.A. , Wiggins , K.J. , Hawley , C.M. et al. ( 2009 ). Intradermal versus intramuscular hepatitis B vaccination in hemodialysis patients: a prospective open-label randomized controlled trial in nonresponders to primary vaccination . Am. J. Kidney Dis. 54 ( 1 ): 95 – 103 .
- Chanchairujira , T. , Chantaphakul , N. , Thanwandee , T. , and Ong-Ajyooth , L. ( 2006 ). Efficacy of intradermal hepatitis B vaccination compared to intramuscular vaccination in hemodialysis patients . J. Med. Assoc. Thail. 89 ( Suppl 2 ): S33 – S40 .
- Propst , T. , Propst , A. , Lhotta , K. et al. ( 1998 ). Reinforced intradermal hepatitis B vaccination in hemodialysis patients is superior in antibody response to intramuscular or subcutaneous vaccination . Am. J. Kidney Dis. 32 ( 6 ): 1041 – 1045 .
- Waite , N.M. , Thomson , L.G. , and Goldstein , M.B. ( 1995 ). Successful vaccination with intradermal hepatitis B vaccine in hemodialysis patients previously nonresponsive to intramuscular hepatitis B vaccine . J. Am. Soc. Nephrol. 5 ( 11 ): 1930 – 1934 .
