Establishment of Dialysis-related Infection Surveillance System

Abstract

  Infections in patients under hemodialysis have adverse consequences such as increased morbidity and mortality, costs, and hospitalization rates. In order to prevent infections in these patients, a national system to survey infections in the dialysis setting was needed. There was no such system in Japan, so we created, tested and established a system with some modification of criteria for infections. From March 2008 to March 2010, 19 centers participated in the system and monitored several outcome events, including infections of the vascular access site. The infection rate of non-cuffed catheter was remarkably high among various access types. Compared with The Dialysis Surveillance Network data in US, the infection rates of non-catheter access were lower, whereas that of non-cuffed catheter was lower. There was a contradiction in our initial criteria for infection, so we added modifications. Otherwise, the surveillance system worked very efficiently. The next step is to decrease infection rates through surveillance, especially those of non-cuffed catheters. This would require detailed analysis of the infected cases and standardization of infection control practices in managing dialysis catheters. We believe that continuing data collection through our established surveillance system would contribute to this purpose.