Infection Associated with Temporary Central Venous Catheter for Hemodialysis: A Review of 5 Years Experience

Background. To investigate the risk factors of the infection of temporary central venous catheterization and compare these results to that of previous studies, we collected 700 events of catheter insertion for hemodialysis patients who needed a temporary vascular access. Methods. We performed a retrospective study of 700 events (1350 catheter insertions) which recorded temporary central venous catheter insertions from January 1997 to November 2001. The demographic parameters and data of possible contributing factors, such as age, sex, duration and frequency of one treatment course, diabetes mellitus, acute or chronic renal failure, serum albumin and hematocrit level, of central venous catheter-related infections were collected. The above data were analyzed by using student’s t test or chi-square test for univariate analysis. To discover the independent risk factors, variables with probability less than 0.05 were put into binary logistic regression analysis. Results. A total of 85 episodes of catheter-related infection occurred, representing an infection rate of 12.14% of events and incidence of 8.46/1000 catheter-days. The most common isolated pathogen responsible for infection was oxacillin-resistant Staphylococcus aureus. In univariate analysis, there were significant differences demonstrated in the variables of duration of an event, frequency of insertion in one event, serum albumin level and diabetes mellitus between infection and non-infection patients. However, both the frequency of an event and serum albumin level were the independent risk factors in multivariate analysis. Conclusion. Based on our findings, we suggest that decreasing frequency of catheter change and improving the nutritional condition of patients with hypoalbuminemia might reduce the catheter-related infection in hemodialysis patients.