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Dialysis
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Management of Bacteremia Associated with Tunneled-Cuffed Hemodialysis Catheters

GERALD A. BEATHARD
JASN May 1999, 10 (5) 1045-1049; DOI: https://doi.org/10.1681/ASN.V1051045
GERALD A. BEATHARD
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    Table 1.

    Patient groupsa

    GroupnSymptomsExit SiteTreatment
    aXchng, catheter exchange over guidewire; Nutunl, catheter exchange over guidewire with a new tunnel and exit site; Delay, delayed catheter replacement.
    bThe character of the exit site did not influence this group.
    Xchng49MildNormalAntibiotics for 3 wk, catheter exchange
    Nutunl28MildInfectedAntibiotics for 3 wk, catheter exchange, new tunnel and exit site
    Delay37SevereNAbAntibiotics for 3 wk, remove catheter, delay replacement
    • View popup
    Table 2.

    Cure rates for clinical groups

    GroupCulture CureaClinical CurebFailureIndeterminantc
    aNegative blood culture 7 to 10 d after antibiotic therapy complete, plus 45 d free of symptoms.
    bForty-five days free of symptoms.
    cInfection with a new organism, death, or catheter removed before end of 45-d period for unrelated reason.
    Xchng (n = 49)34 (69.4%)9 (18.4%)06 (12.2%)
    Nutunl (n = 28)14 (50%)7 (25%)5 (17.8%)2 (7.1%)
    Delay (n = 37)27 (73%)5 (13.5%)3 (8.1%)2 (5.4%)
    • View popup
    Table 3.

    Explanation of indeterminate group

    GroupNo. IndeterminateDifferent OrganismaCatheter RemovalbDeathc
    aInfection recurred within 45-d period, but with an organism different from the original.
    bThe catheter was removed during the 45-d period for unrelated reasons.
    cDeath was not related to catheter-related bacteremia.
    Xchng6411
    Nutunl22
    Delay211
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    Table 4.

    Microbiologic isolates from 123 episodes of catheter-related bacteremia

    OrganismIsolates, n (%)
    Gram-positive cocci104 (84.5%)
    Staphylococcus epidermidis 46
    Staphylococcus aureus 37
    Enterococcus faecalis 15
    other group D enterococci6
    Gram-positive rods2 (1.6%)
    Corynebacterium species4
    Gram-negative rods41 (33.3%)
    Enterobacter cloacae 11
    other Enterobacter species2
    Pseudomonas species8
    Acinetobacter baumanii 5
    Citrobacter species5
    Serratia species2
    Klebsiella pneumoniae 4
    Proteus mirabilis 1
    Escherichia coli 1
    Agrobacterium radiobacter 1
    Alcaligenes species1
    Acid-fast organism2 (1.6%)
    Mycobacterium fortuitum 2
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Journal of the American Society of Nephrology: 10 (5)
Journal of the American Society of Nephrology
Vol. 10, Issue 5
1 May 1999
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Management of Bacteremia Associated with Tunneled-Cuffed Hemodialysis Catheters
GERALD A. BEATHARD
JASN May 1999, 10 (5) 1045-1049; DOI: 10.1681/ASN.V1051045

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Management of Bacteremia Associated with Tunneled-Cuffed Hemodialysis Catheters
GERALD A. BEATHARD
JASN May 1999, 10 (5) 1045-1049; DOI: 10.1681/ASN.V1051045
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