Retrospective analysis of incidence and risk factors for temporal hemodialysis catheter-related infections

Abstract

A retrospective study was conducted to determine the incidence of central venous catheter (CVC)-related infections in patients on hemodialysis between 2003 and 2004. There were 533 CVC occurring in 439 patients and the median duration of catheterization was 14 days. The incidence of fever associated with CVC was 14% and 11 episodes of CVC-related infections were identified. The incidence of CVC-related infections was calculated to be 1.63 episodes per 1000 catheter days, 0.83 for the internal jugular vein and 8.16 for the femoral vein on subgroup analysis. In cases in which the CVC was placed in the femoral vein, the incidence of fever was significantly higher, compared to that in placement in the internal jugular vein (7.4% vs. 1.1%, respectively). Multiple logistic regression analysis demonstrated that CVC insertion in the femoral vein was a significant risk factor for CVC-related infection (Odds ratio, 4.98 ; 95% confidence interval, 1.34 to 18.54 ; p=0.017) and fever (Odds ratio, 2.87 ; 95% confidence interval, 1.55 to 5.30 ; p<0.001). Gram-positive organisms were isolated in all cases of infection, and gram-negative organisms and fungi were less frequent. It is necessary to carry out a prospective study, to establish a superior system for the management of CVCs and to clarify risk factors that are associated with CVC-related infections in dialysis patients.