Kidney Week

Abstract: TH-PO880

Seasonal Variations in Blood Stream Infections in Hemodialysis Patients in the Midwest

Session Information

• Dialysis: Infection
  November 02, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Dialysis

• 610 Dialysis: Infection

Authors

• Reviriego-Mendoza, Marta, Fresenius Medical Care North America, Waltham, Massachusetts, United States

Marta Reviriego-Mendoza,

• Rosen, Sophia, Fresenius Medical Care North America, Waltham, Massachusetts, United States

Sophia Rosen,

• Han, Hao, Fresenius Medical Care North America, Waltham, Massachusetts, United States

Hao Han,

• Blanchard, Thomas C, Fresenius Medical Care North America, Waltham, Massachusetts, United States

Thomas C Blanchard,

• Jackson, Jerry W., FMC Patient Safety Council, Mountain Brk, Alabama, United States

Jerry W. Jackson,

• Brennan, Julia I., Spectra Laboratories, Rockleigh, New Jersey, United States

Julia I. Brennan,

• Larkin, John W., Fresenius Medical Care North America, Waltham, Massachusetts, United States

John W. Larkin,

• Usvyat, Len A., Fresenius Medical Care North America, Waltham, Massachusetts, United States

Len A. Usvyat,

• Kotanko, Peter, Renal Research Institute, New York, New York, United States

Peter Kotanko,

• Hymes, Jeffrey L., Fresenius Medical Care North America, Waltham, Massachusetts, United States

Jeffrey L. Hymes,

• Maddux, Franklin W., Fresenius Medical Care North America, Waltham, Massachusetts, United States

Franklin W. Maddux,

Background

Blood stream Infections (BSIs) are the most common cause of morbidity and second leading cause of mortality in hemodialysis patients (HD). Environmental variations, particularly heat and humidity, are known to promote pathogenic growth and be associated with the incidence of BSIs and the worsening of clinical conditions. We aimed to study whether seasonal changes in the Midwestern area of the United States are associated with the variations in BSI rates in hemodialysis patients.

Methods

We collected data from HD patients treated at Fresenius Kidney Care clinics in the Midwest region from Jan-2014 through Dec-2016. This region was selected due to its more demarcated seasonal changes. Clinics included were those from the following states: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin. The average monthly BSIs were calculated for HD patients and the association between the mean BSI rate and season was analyzed and plotted using a seasonally varying function that was optimized to the data using a least-squared method (Figure 1).

Results

We observed a distinct seasonal variations in BSI rates with a mean fluctuation of 9.25% below and above during July versus February of 2014-2016, respectively. Although BSI rates appeared to increase during warmer months, we observed a 34.3% decrease in BSI rates in the Midwest from 2014 to 2016.

Conclusion

Our findings suggest that seasonal variability is associated with alterations in BSI rates. In the Midwest, the highest BSI rates were observed during warmer months. The downward trends in BSI rates may be representative of improvements in infection control in HD facilities. Further analyses are warranted to confirm these results.