Abstract: SA-PO999
Bloodstream Infections in Relation to Environmental Cultures in 12 Dialysis Units in New York City
Session Information
- Hemodialysis and Frequent Dialysis - V
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Alnazari, Nasser Mohammad, Elmhurst Hospital Center, Elmhurst, New York, United States
- Yaphe, Sean, Henry Ford Hospital, Royal Oak, Michigan, United States
- Weiss, Steven, Atlantic Dialysis Management Services, New York, New York, United States
- Coritsidis, George N., Icahn school of medicine at Mount Sinai, New York, New York, United States
Background
Infections are an important complication of end-stage renal disease (ESRD) and represent a significant contribution to morbidity and mortality rates. Central venous catheters (CVC) contribute to bloodstream infections (BSI). We examine environmental cultures in 12 units of a small dialysis organization (SDO) in New York City in comparison to bloodstream infection surveillance data to discern whether a potential association exists.
Methods
Direct and non-direct care staff members and the dialysis unit environment (dialysis chair, dialysis machine, laptop, television remote, doorknobs, countertops, etc.) were cultured. Jewelry worn and method of hand hygiene were noted. Cultures that grew normal flora, or airborne contaminate were considered negative. This data was compared with the number of bloodstream infections in 2018 and standardized infection ratio (SIR) of CVC BSI.
Results
A total of 560 environmental cultures were collected: 349 from the dialysis environment and 211 from staff. Of the total cultures, 25% were positive, while 18.5% of staff cultures were positive. 56% of staff performed hand hygiene immediately prior to culture: 6.2% with alcohol-based sanitizer, 49.2% with soap and water, and 0.5% with both. 18.5% of staff also wore jewelry, namely non-direct care personnel. Table 1 displays the percentage of all positive cultures and positive direct-care staff cultures in each unit, as well as their associated number of BSIs and SIR.
Conclusion
The 12 units of this SDO have BSI rates that are lower than predicted. Additionally, environmental cultures are in large majority negative. This suggests that these dialysis units are following infection protocol and reducing the spread of BSIs. Infections that do arise may be stemming from other environmental sources, which include the home environment and other healthcare settings. Staff is not following the latest CDC guidelines regarding using hand sanitizer preferentially over hand washing, which is an opportunity for education and improvement