Abstract: SA-PO0458
Acinetobacter Bacteremia in Patients with ESKD and Tunneled Dialysis Catheters
Session Information
- Dialysis: Vascular Access
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 803 Dialysis: Vascular Access
Authors
- Zaman, Jesan, Emory University School of Medicine, Atlanta, Georgia, United States
- Owosela, Babajide O, Emory University School of Medicine, Atlanta, Georgia, United States
- Gammada, Leilani E., Tulane University School of Medicine, New Orleans, Louisiana, United States
- Niyyar, Vandana Dua, Emory University School of Medicine, Atlanta, Georgia, United States
- Cobb, Jason, Emory University School of Medicine, Atlanta, Georgia, United States
Background
Sepsis is the second leading cause of death in ESKD patients. Catheter-related bloodstream infections are a significant source of morbidity and mortality. There is a paucity of data of Acinetobacter infections in the ESKD patient population which have been limited to a few case reports mostly in peritoneal dialysis. We present the largest case series of Acinetobacter bacteremia in ESKD hemodialysis patients using a tunneled dialysis catheter for hemodialysis access.
Methods
Reviewed records of Acinetobacter bacteremia in patients at Emory University Hospital Midtown and Emory Dialysis (academic outpatient HD centers) from 2010 – 2024. Patients with arteriovenous fistula (AVF) or arteriovenous graft (AVG) as primary HD vascular access were excluded.
Results
10 cases with Acinetobacter bacteremia, 8 cases included (all Acinetobacter baumannii and pan-sensitive), and 2 excluded due to AVG or AVF primary HD access. Average HD vintage: 2.98 years. Tunneled HD catheter access – internal jugular (n=7) and left femoral (n=1). Common comorbidities included hypertension (n = 6), diabetes mellitus (n=4), and HIV (n=4). At the time of presentation: febrile (n = 3), mean peak WBC 8.2 x 103/µL with only 1 patient >10 x 103/µL. Patients treated with antibiotics for 2-6 weeks. All 8 patients had tunneled HD catheter removed. Three patients with guidewire catheter exchange, 2 with HD catheter removed and line holiday (1 for 2 days and other for 5 days) before tunneled HD catheter replaced, and 3 patients had maturing AVG/AVF with tunneled HD catheter removed and transitioned to the AVG/AVF. No reported documentation of recurrent Acinetobacter bacteremia (n=6).
Conclusion
Acinetobacter bacteremia is associated with hospital-acquired infections & no patient had recent hospitalization, but we argue that outpatient HD centers are possible risk factors. Three of the 8 patients had pre-existing maturing AVG or AVF and were able to successfully transition to use of the AVG/AVF, and quick removal of tunneled dialysis catheters could have prevented 3 of the cases. Of note, 50% of the patients had HIV and guidewire catheter exchange (n=3) was a successful treatment therapy. This case series provides useful information about demographics and outcomes in ESKD patients with Acinetobacter bacteremia attributed to tunneled dialysis access.