Abstract: SA-PO964
Clinical Outcome in the Use of Biopatch in Preventing CRBSI Among Hemodialysis Patients via Hemodialysis Catheters in a Private Tertiary Hospital
Session Information
- Dialysis: Vascular Access - II
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 704 Dialysis: Vascular Access
Authors
- Gallero, Melani T., St. Luke's Medical Center, Quezon City, Philippines
- Bayaca, Jeanne Bernal, Goodfellow Pharma Corporation, Pasig, Philippines
Background
According to CDC, CLABSI result in thousands of deaths each year. Biopatch is a novel catheter dressing impregnated with chlorhexidine gluconate, used in conjunction with the standard catheter dressing to prevent CRBSI.
Methods
This is a retrospective cohort study design with target population of in hospitalized and outpatients who had HD via HD catheters exclusively in St. Luke’s Medical Center–QC, a private tertiary hospital from January 2013 to December 2017.
Results
A total of 427 HD patients via HD catheters (IJ,Femoral,Permanent Catheter) met the inclusion criteria. Of which, 255 HD patients on biopatch and 172 without biopatch.117 in the biopatch group developed CRBSI and 72 patients in those without biopatch. The incidence rate of CRBSI with biopatch was 6.47/1000 catheter days (6 cases of CRBSI/1000 Catheter days) and was higher than those without biopatch, 3.4/1000 catheter days (3 cases of CRBSI/1000 Catheter days) and was statistically significant (P=0.002;HR, 1.614 times among those with biopatch as compared to those without biopatch). Those with significant association with CRBSI among those with biopatch were aged 18 to 60 y/o (P=0.001;HR, 2.841), male patients (P=0.034;HR, 1.57), female patients (P=0.025;HR, 1.717), those with ESRD secondary to DKD (HR, 1.67), other causes of ESRD from solitary kidney, CTIN (P=0.013;HR, 6.564), those with other causes of AKI (P=0.000) and PVD (P=0.000) as compared to those without biopatch. Of the organisms isolated, Klebsiella pneumonia was common among those with biopatch and Pseudomonas aeruginosa among those without biopatch. The risk of CRBSI using permanent catheter with biopatch was 2.853 (P=0.000).
Conclusion
The use of Biopatch had a higher incidence rate of CRBSI among HD patients with biopatch compared to those without biopatch.There was significant association with CRBSI and those with biopatch </=60 y/o, male and female, those with ESRD due to DKD, other causes of ESRD, other causes of AKI and PVD. Majority of organisms isolated were gram positive bacteria, Staphylococcus epidermidis, both in HD patients with and without biopatch. Among CRBSI patients who had Klebsiella pneumonia, the use of biopatch may not be preventive in the development of CRBSI. However, among CRBSI patients with Pseudomonas aeruginosa, biopatch may decrease the risk of CRBSI.