Abstract: SA-PO1001
Microbiome in Tunneled Catheters of Patients Receiving Maintenance Hemodialysis
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
- Wadhwa, Anuradha, Loyola University Medical Center, Maywood, Illinois, United States
- Jameson, Travis R., Loyola University Medical Center, Maywood, Illinois, United States
- Zilliox, Michael, Loyola University Medical Center, Maywood, Illinois, United States
- Vellanki, Kavitha, Loyola University Medical Center, Maywood, Illinois, United States
- Bansal, Vinod K., Loyola University Medical Center, Maywood, Illinois, United States
- Ling, Benjamin, Loyola University Medical Center, Maywood, Illinois, United States
- Schneider, Julia, Loyola University Medical Center, Maywood, Illinois, United States
- Kramer, Holly J., Loyola University Medical Center, Maywood, Illinois, United States
Background
Sepsis is one of the leading causes of morbidity and mortality in patients receiving maintenance hemodialysis via catheter. Bacteremia in dialysis patients generally results from contamination of the catheter lumen (biofilm). Dialysis catheter lumen is instilled with sterile heparin solution at the end of dialysis treatment and discarded prior to next treatment. The aim of our pilot study was to identify the presence and characteristics of microbiome in heparin fluid in tunneled catheters.
Methods
For 20 hemodialysis patients with catheters, 3 ml samples of heparin (mixed with blood) in catheter lumen was collected. Bacterial DNA was isolated and amplified using multiple displacement amplification; 16S rRNA sequence analysis was used to identify and characterize the microbiome. Sample diversity of the sequence positive composition was quantified using the inverse Simpson, and Chao indices.
Results
Among the 20 patients with a tunneled hemodialysis catheter, median age was 54 (range 20-80 years), 50% were male, and race was African American in 50% and white in 20% and rest were Hispanic or Asian. Median catheter days was 127 (range 42 to 347 days). Seven of the 20 catheter fluid samples had greater than 200 reads. One specimen was dominated (greater than 50%reads) by the genera Lactobacillus. This patient with dominance of Lactobacillus species in the catheter microbiome was a young female with catheter duration of 344 days. The other 6 showed no dominant species and showed high diversity with inverse Simpson Index 6.25 (95% CI 4.34, 11.11) and Chao index of 35.22 (95% CI 27.42, 43.02).
Conclusion
The microbiome of heparinized fluid in tunneled dialysis catheters does not appear to be sterile. Information on the catheter biome may be used to predict future blood stream infections and/or to develop protocols for infection prevention.