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Abstract: SA-PO1002

Change in the Incidence and Pattern of Staphylococcus aureus Bacteraemias in Haemodialysis Patients: 12-Year Single-Centre Experience

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Stanley, Moira, Epsom & St. Helier University Hospitals NHS Trust, Surrey, United Kingdom
  • Hurst, Jonathan William, Epsom and 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, Surrey, United Kingdom
Background

Patients on haemodialysis (HD) are greater risk of infection if they dialyse through lines, than with via arteriovenous fistulae or grafts. The most commonly implicated organism is Staphylococcus aureus (SA), which can cause metastatic infections e.g endocarditis, osteomyelitis. There has been a focus on reducing the incidence of infections, especially methicillin resistant SA (MRSA).
We looked at the incidence of methicillin sensitive SA (MSSA) and MRSA in HD patients with SA bacteraemia at our centre over the last 12 years.

Methods

Data were collected from the hospital’s microbiology database of all the SA bacteraemias in HD patients between 2007 and 2018.

Results

There were 261 bacteraemias in 1361 patients, from a total of 32,000 dialysis episodes. 62.8% were male. Median age was 67 years (range 18-96). Blood cultures grew MSSA - 71%, MRSA - 29%. 78% occurred in patients dialysing via lines. The incidence of infections fell from 50 in 2007 to 15 in 2018. The proportion of MSSA infections increased however.

Conclusion

There was a significant reduction in SA bacteraemias, but an increase in the proportion of MSSA bacteraemias. It is important not to allow the reduction in numbers (in particular of MRSA) to lead to complacency in the efforts to reduce the numbers of MSSA and other infections in this particularly vulnerable group of patients.