Résumé
Continuous haemodialysis is commonly used in patients with end stage renal disease. Catheter- related bacteraemia [CRB] is a major cause of morbidity in haemodialysis patients. This retrospective study was carried out to determine the incidence, clinical profile and morbidity and mortality of CRB in Benghazi Nephrology Centre. All hospital records of hemodialysis patients with catheters placed in hemodialysis Unit at Benghazi Nephrology Centre in the period of 1[st] January 2003 through 31[st] December 2006 were retrospectively analysed for CRB. In all cases, pyrexia in patients with central venous catheters was considered to be due to CRB until proved otherwise. Catheter was taken out, even in case of permanent [tunneled] one, and the tip was sent for culture and sensitivity. The mean age +/- SD of hemodialysis patients was 56 +/- 10.4 years [range = 26-70 years] and the male to female ratio was 1:3:1. The overall incidence of CRB was 5.7 episodes per 1000 catheters - days. Staphylococcus species were the most predominant pathogens isolated. Two patients died due to septicaemia and one patient had meningitis due to Gram-negative bacteria. Antimicrobial therapy with vancomycin, ceftriaxone and gentamicin was effective in 91% of CRB cases. The present study has shown that CRB is not uncommon complication in patients using dialysis catheters at Benghazi Nephrology Centre. However, it occurs less commonly with tunnelled than non-tunnelled central venous catheters Stiphylococcus spp. Being the most commonly isolated pathogens, antimicrobial therapy should cover Staphylococcus species unless culture result indicates otherwise