Abstract: FR-PO762
Infections of Tunneled and Non-Tunneled Central Venous Catheters Associated with the Use of 10% Povidone-Iodine versus 2% Chlorhexidine in Chronic Hemodialysis
Session Information
- Hemodialysis: Vascular Access - II
November 03, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Dialysis
- 603 Hemodialysis: Vascular Access
Authors
- Arvizu-Hernandez, Mauricio, National Medical Science and Nutrition Institute Salvador Zubiran, México city, México city, Mexico
- Vega, Olynka, National Institute of Medical Sciences, Mexico, Distrito Federal, Mexico
- Correa-Rotter, Ricardo, National Medical Science and Nutrition Institute Salvador Zubiran, México city, México city, Mexico
Background
Vascular access (VA) infections are a problem in patients on hemodialysis (HD), representing the second cause of morbidity and mortality. The ideal VA is the arterio-venous fistula, in our environment a high number of patients start and stay for a longer than desired on catheters. The use of 2% chlorhexidine solution (2% CHX) for the management of exit site of VA on HD can impact positively the number of catheter infections.
Methods
Retrospective cohort study performed in our Institute HD unit, where 10% povidone-iodine solution (PI) was previously used and since March/2015, was substituted by 2% CHX. We assessed the rate of VA (cathether related) infections from Sep/13 to Aug/16 (Sept/13-Feb/2015 PI and Mar/15-Aug/16 use of 2% CHX). Incidence of infections was analyzed on a monthly basis, identifying number and clinical characteristics of the infection. We calculated the rate of infections per 1000 days/cath/patient. The use of PI vs 2% CHX periods were compared.
Results
During the 36 month study period, a total of 33 infections were identified (0,91 infect/month). The highest infection rate was observed during the use of the PI, both in tunneled and non-tunneled catheters. On the basis of cumulative incidence rates, calculating the RR; the use of PI in both types of catheters, as compared to use of 2% CHX, has a RR of 4.0 (tunneled RR=3.6 and non-tunneled RR=7.0).
Conclusion
Our study demonstrated clearly that the use of 2% CHX in patients with temporary cathether vascular accesses on HD, reduces the risk of infection of both the tunneled and non-tunneled catheters.