ABSTRACT
Dual-lumen cuffed central venous catheter [perm-cath] is an alternative vascular access in maintenance hemodialysis Infection however is a major problem associated with long-term central venous catheters. This study assesses the spectrum of catheter related bacterial infectkin among hemodialysis patients. Charts of 174 patients were reviewed during The period between January 2005 and December 2006. Quantitative blood culture was obtained simultaneously from the catheter and from a peripheral vein when catheter related infection is suspected. Episodes of catheter related infection were registered including the causative bacteria. 76perm-cath double-lumen catheters rooted in 76 [43.7%] hemodialysis patients. Seventy nine episodes of catheter related bacteria in 45 [59%] patients were analyzed Six [13.33%] patients had more than one episode of catheter related infection. The rate of infection is equal to 3.3 per hundred patient-month treatment The causative bacteria included Gram-positive organisms in 51 [64.6%]. Staphylococcus aureus in 33 [41.8%] episodes. Methicillin resistant staphylococcus aureus [MRSA] was detected in 25 [31.6%] episodes. Coagulase negative staphylococcus species in 9[11.4%] episodes, and enterococci in 6[7.5%] episodes. Gram-negative bacteria were the cause of infection in 28 [35.4%] episodes. Pseudomonas was isolated in 6[7.5%] episodes, acinetobacter in 5[6.3%] episodes, and E-coli in 5[6.3%] episodes. Other bacteria were the cause of infection in 15[18.9%] episodes. Bacteremia was reported in 47[59.5%] episodes. Isolated exit site infection was reported in 26[32.9%] episodes. Concomitant exit site infection and septicemia was reported in 6 [7.5%] episodes. Seventy five [95%] episodes were cured with proper antibiotics without catheter removal and 4 episodes [5%] required catheter removal. This study dearly demonstrated that MRSA is most common cause of perm-cath infection in hemodialysis patient. Early treatment and or catheter removal reduces patients' morbidity. Exit site infection should be treated punctually