Abstract: SA-PO1095
Epidemiology and Clinical Outcomes of Staphylococcus aureus Bacteraemias in Haemodialysis Patients; 12-Year Single-Centre Experience
Session Information
- Vascular Access - II
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 704 Dialysis: Vascular Access
Authors
- Hurst, Jonathan William, Epsom & St. Helier University Hospitals NHS Trust, Surrey, United Kingdom
- Stanley, Moira, Epsom & St. Helier University Hospitals NHS Trust, Surrey, United Kingdom
- Rangaiah, Jayakeerthi, Epsom & St. Helier University Hospitals NHS Trust, Surrey, United Kingdom
- Makanjuola, David, Epsom & St. Helier University Hospitals NHS Trust, Surrey, United Kingdom
Background
Patients on haemodialysis are at risk of access associated infections. The risk is greater in patients dialysed through lines, than those dialysing via arteriovenous fistulae (AVF) or grafts (AVG). Studies have shown that the most commonly implicated organism is Staphylococcus aureus (SA), which has a tendency to cause metastatic infections e.g endocarditis, osteomyelitis. We decided to look at the incidence and clinical outcomes in haemodialysis (HD) patients with SA bacteraemia in patients at our centre over the last 12 years.
Methods
Data were collected from the hospital’s microbiology database of all the confirmed bacteraemias in HD patients between 2007 and 2018. We looked at the demography, type of dialysis access, and the outcomes following the bacteraemias.
Results
There were 261 bacteraemias in 1361 patients who had a cumulative total of 32,000 dialysis episodes over the 12 year period. Of the patients with bacteraemias, 164 (62.8%) were male. The median age was 67 years (range 18-96). The dialysis access at the time of the bacteraemia was as follows: AVF/AVG 57(22%), dual access - AVF or graft + line - 50 (20%), dialysis line 147 (56%), not documented 7 (3%). The blood cultures grew methicillin sensitive SA (MSSA) in 71% and methicillin resistant SA in 29% of cases. 204 (77%) cases occurred in patients dialysing through lines. Details about complications were available in 199 patients and are shown in Table 1.
Conclusion
Our data show that the bacteraemias and complications were most common in patients dialysing with lines, and emphasise the importance of trying to achieve dialysis through AVFs or grafts as soon as is possible.
Table 1 – Complications following SA bacteraemias
| COMPLICATION | NUMBER (%) | LINES | AVF/GRAFTS |
| Discitis | 5 | 4 | 1 |
| Endocarditis | 13 | 9 | 4 |
| Septic arthritis | 4 | 3 | 1 |
| Death | 26 | 21 | 5 |
| Total | 48 | 37 (77%) | 11 (23%) |