Conducta frente a la sospecha de infección relacionada a catéter venoso central para hemodiálisis

Julio Medina; María Rodríguez; Rosana Astesiano; Eduardo Savio; Francisco González; Cristina Bazet; Verónica Seija

Authors

Julio Medina Universidad de la República, Facultad de Medicina, Cátedra de Enfermedades Infecciosas, Asistente. Especialista en Enfermedades Infecciosas y Medicina Intensiva
María Rodríguez Especialista en Enfermedades Infecciosas
Rosana Astesiano Universidad de la República, Facultad de Medicina, Medicina Intensiva, Ex Residente. Postgrado de la Cátedra de Nefrología
Eduardo Savio Universidad de la República, Facultad de Medicina, Cátedra de Enfermedades Infecciosas, Profesor
Francisco González Universidad de la República, Facultad de Medicina, Cátedra de Nefrología, Profesor
Cristina Bazet Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Laboratorio Clínico, repartición Microbiología, Profesora Agregada
Verónica Seija Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Departamento de Bacteriología y Virología, Prof. Adjunto. Departamento de Laboratorio Clínico. Repartición Microbiología, Asistente

Keywords:

CENTRAL VENOUS CATHETERISM, KIDNEY DIALYSIS, INFECTION CONTROL

Abstract

Background. To determine central venous catheter related infection (IRcat) in carriers of central venous catheter (CVC) is of vital importance in order to avoid unnecessary removal of CVC.
Objectives. 1. to determine the frequency of the removed CVC because of suspicion of IRcat (not confirmed). 2. to identify clinical factors that improve IRcat diagnose.
Methods. The observational study was conducted from May, 1 to September, 30, 2003 at the Nephrology Department (Hospital de Clínicas). The inclusion criteria were as follow: patients of the Nephrology Department over 18 years old who underwent an hemodialysis CVC.
Results. One hundred and seven consecutive patients carriers of CVC were enrolled in the study: 50 CVC (46.7%) were removed because of infectious causes and the left 57 (53.3%) due to other causes.
The first group was divided in two: a) removed CVC with subsequent IRcat, n = 22 (44%); and b) removed CVC without IRcat, n = 28 (56%).
A 20-variable comparison using an univariated analysis was done: a 14-day CVC was associated with temperature corresponding to IRcat (p = 0.02, OR = 2.1, IC 95% = 1.2-3.7).
Conclusions. Fifty six percent (56%) of hemodialysis CVC removed because of infectious causes were not confirmed as infection process. A 14-day CVC was associated with IRcat in the cases of infection process.

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