Abstract: PUB219
Mortality within 12 Months following Bacteraemia in Patients Dialysing through Tunnelled Lines: Effect of the Organism Isolated
Session Information
Category: Dialysis
- 803 Dialysis: Vascular Access
Authors
- Dhlandhlara, Takudzwa Joseph, St Helier Hospital, Carshalton, Surrey, United Kingdom
- Makanjuola, David, St Helier Hospital, Carshalton, Surrey, United Kingdom
Background
Haemodialysis (HD) patients are at risk of dialysis access-associated infections. The risk is more in patients dialysing with lines. The most commonly implicated organism is Staph aureus (SA), accounting for 27-39% of bacteraemias. SA has a tendency to cause metastatic infections e.g. endocarditis, septic emboli, and discitis.
We looked at bacteraemias in patients dialysing with lines to see if there was a difference in the mortality related to the kind of organism isolated.
Methods
This retrospective cohort study was on HD patients who had positive blood cultures between 2019 –2022. Data on blood cultures and survival were collected from an electronic database and statistical analysis was done with Microsoft Excel.
Results
There were 506 bacteraemias in 275 patients. 168 were male. Median age at time of bacteraemia was 67 years (range 19-91). Organisms responsible for the bacteraemias were: Gram negatives 93 (23.8%), Gram positives 296 (75.7%), of which staphylococcus aureus SA species were 85 (85.7%).
The percentage of patients who died within 12 months of a bacteraemia was 37% in the whole population. For those with Gram negative bacteraemia, it was 30% and for those with Gram positive bacteraemia, it was 39%. In those with SA bacteraemia, the mortality rate was 49%.
Conclusion
While the causes of death within 1 year of the infection are varied it is intriguing that the lowest survival of patients was in the group of those who had had SA bacteremia.
Our data suggest that the type of organism causing the bacteraemia is important, as the mortality in those with SA appears worse compared with other Gram positive and with Gram negative organisms. This might be due to the difficulty eradicating SA as it causes a biofilm on the line, and can cause metastatic infections.