Abstract: TH-PO883

An Outbreak of Catheter-Related Bacteremia on Hemodialysis Patients Caused by Serratia marcescens

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

  • Delgado, Omar Ignacio, Regional General Hosptial 46, Mexican Institute of Social Security, Guadalajara, Mexico, Guadalajara, Mexico
  • Soto-Vargas, Javier, Regional General Hosptial 46, Mexican Institute of Social Security, Guadalajara, Mexico, Guadalajara, Mexico
  • López, Heriberto Reyes, Regional General Hosptial 46, Mexican Institute of Social Security, Guadalajara, Mexico, Guadalajara, Mexico
  • Topete reyes, Jorge fernando, Regional General Hosptial 46, Mexican Institute of Social Security, Guadalajara, Mexico, Guadalajara, Mexico
  • Salazar lopez, Ma anabel, Regional General Hosptial 46, Mexican Institute of Social Security, Guadalajara, Mexico, Guadalajara, Mexico
  • Martinez Garcia, Oscar César, Regional General Hosptial 46, Mexican Institute of Social Security, Guadalajara, Mexico, Guadalajara, Mexico
  • Pazarin-Villase?or, Leonardo, Regional General Hosptial 46, Mexican Institute of Social Security, Guadalajara, Mexico, Guadalajara, Mexico
Background

Catheter related infections in hemodialysis patients are associated with a great morbidity, hospitalization, and death. Serratia marcescens it has been reported to cause nosocomial infection due to their ability to colonize antiseptic soaps. Our objective was to present an outbreak of S. marcescens in HD patients.

Methods

In our HD unit there are 27 HD machines, with a total of 945 treatments at week, we have 370 maintenance HD patients with 2 or more sessions per week. During the period of April to May 2015 ninety-five HD patients reported a bacteremia episode during, of which 56 cases were positive to S. marcescens. An epidemiologic search was conducted finding positive cultures on antiseptic soap used by medical personal.

Results

There were 95 cases of bacteremia, of which S. marcescens represented the 58.9% (56) of the cases, 14 (16.1%) we were unable to localize and agent, and other pathogens had a frequency no bigger than 2%. The median age was 35 years (IQR 25-53), 62 (65.33%) were male, 65 (68.4%) patients had HD thrice weekly, and 30 (31.6%) had twice or less HD sessions per week, 46 (48.4%) patients received their treatment on nocturnal hours, 27 (28.4%) on the morning hours and 12 (12.6%) on the evening and there were no association between the time of the HD sessions and the need for hospitalization and catheter removal. Seventy-one percent of the patients had a non-tunneled catheter, 29% had a tunneled catheter, and there were no cases in patients who had FAV as theirs venous access. The antibiotic treatment was standardized according to sensibility analysis of the cultures consisting of amikacin in lock therapy and systemic ciprofloxacin. There were no fatal cases, but the infection results in the need of hospitalization and access removal in four cases (4.2%).

Conclusion

The appearance of S. marcescens in blood cultures of HD patients units should alert the possibility of an outbreak, given its ability to colonize antiseptic substances. Early and targeted antibiotic treatment as well as rutinary microbiology screening is recommended for the prevention of outbreaks.