Emergence of antibiotic resistance in bloodstream infections associated with catheters in hemodialysis patients: a prospective observational study

Background: Catheter-related bloodstream infections (CRBSIs) are a significant cause of hospitalization and mortality among hemodialysis patients. Incidence rates and resistance patterns vary widely. Recent studies show a rise in CRBSIs caused by multidrug-resistant organisms (MDROs). This study...

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Main Authors: Mohammad Bhat, Danish Muqbool, Rayees Yousuf, Manzoor Parry, Amir Farooq, Muzamil Wani, Imran Khan, Imtiyaz Wani, Muzafar Wani
Format: Article
Language:English
Published: Troika Publisher 2025-06-01
Series:Journal of Renal and Hepatic Disorders
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Online Access:https://jrenhep.com/index.php/jrenhep/article/view/211/358
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author Mohammad Bhat
Danish Muqbool
Rayees Yousuf
Manzoor Parry
Amir Farooq
Muzamil Wani
Imran Khan
Imtiyaz Wani
Muzafar Wani
author_facet Mohammad Bhat
Danish Muqbool
Rayees Yousuf
Manzoor Parry
Amir Farooq
Muzamil Wani
Imran Khan
Imtiyaz Wani
Muzafar Wani
author_sort Mohammad Bhat
collection DOAJ
description Background: Catheter-related bloodstream infections (CRBSIs) are a significant cause of hospitalization and mortality among hemodialysis patients. Incidence rates and resistance patterns vary widely. Recent studies show a rise in CRBSIs caused by multidrug-resistant organisms (MDROs). This study aims to determine the incidence, microbiological profile, antibiogram and outcomes of CRBSIs in hemodialysis patients at our institution. Methods: This prospective single center observational study included all patients initiating hemodialysis with central venous double-lumen catheters. Results: During the study, 240 catheters were inserted in 240 patients. A total of 48/240 (20%) developed CRBSI with 41/48 (85.4%) having culture-positive probable CRBSI and 07/48 (14.6%) having culture-negative possible CRBSI. Concomitant exit site infection was present in 09/48 (18.8%). The CRBSI incidence rate was 1.46 episodes per 1000 catheter days, based on 48 episodes over 32,782 catheter days. The mean time to CRBSI was 204.6 ± 87.1 days. Gram-positive bacteria were cultured in 15 cases (31.3%), Gram-negative bacteria in 26 cases (54.2%), and 7 cases (14.6%) had negative culture. Coagulase negative Staphylococcus Aureus (CoNS) was the most common Gram-positive pathogens isolated, making up 46.7% of the cases. Klebsiella pneumonia, Pseudomonas, and Acinetobacter species were identified as the most prevalent Gram-negative pathogens (n = 06/26 each; 23.1%. Among 8 cultured Gram-negative bacterial species, resistance patterns observed was Ampicillin: 4/4 tested (100.0%), Quinolones: 4/6 tested (66.7%), Clotrimazole: 3/5 tested (60.0%), Carbapenems: 3/6 tested (50.0%), Gentamicin: 2/5 tested (40.0%), Amikacin: 1/3 tested (33.3%), and Piperacillin-Tazobactam: 1/5 tested (20.0%). A total of 39/48 catheters were salvaged. Conclusions: CRBSI remains a significant issue in patients using central venous catheters. The rise of multidrug-resistant Gram-negative infections necessitates stricter measures, including improved hygiene, surveillance and long-term vascular access. Proper cultures should precede empirical antibiotic therapy, and healthcare centers should tailor their antibiotic policies to local susceptibility patterns.
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spelling doaj-art-19e408cb3448421b84ab2aa790367d5b2025-08-20T03:27:18ZengTroika PublisherJournal of Renal and Hepatic Disorders2207-37442025-06-0191121710.63268/jrenhp.v9i1.211Emergence of antibiotic resistance in bloodstream infections associated with catheters in hemodialysis patients: a prospective observational studyMohammad Bhat0Danish Muqbool1Rayees Yousuf2Manzoor Parry3Amir Farooq4Muzamil Wani5Imran Khan6Imtiyaz Wani7Muzafar Wani8Department of Nephrology, Sheri-Kashmir Institute of Medical Sciences, 190011 Srinagar, IndiaDepartment of Nephrology, Sheri-Kashmir Institute of Medical Sciences, 190011 Srinagar, IndiaDepartment of Nephrology, Sheri-Kashmir Institute of Medical Sciences, 190011 Srinagar, IndiaDepartment of Nephrology, Sheri-Kashmir Institute of Medical Sciences, 190011 Srinagar, IndiaDepartment of Nephrology, Sheri-Kashmir Institute of Medical Sciences, 190011 Srinagar, IndiaDepartment of Nephrology, Sheri-Kashmir Institute of Medical Sciences, 190011 Srinagar, IndiaDepartment of Nephrology, Sheri-Kashmir Institute of Medical Sciences, 190011 Srinagar, IndiaDepartment of Nephrology, Sheri-Kashmir Institute of Medical Sciences, 190011 Srinagar, IndiaDepartment of Nephrology, Sheri-Kashmir Institute of Medical Sciences, 190011 Srinagar, IndiaBackground: Catheter-related bloodstream infections (CRBSIs) are a significant cause of hospitalization and mortality among hemodialysis patients. Incidence rates and resistance patterns vary widely. Recent studies show a rise in CRBSIs caused by multidrug-resistant organisms (MDROs). This study aims to determine the incidence, microbiological profile, antibiogram and outcomes of CRBSIs in hemodialysis patients at our institution. Methods: This prospective single center observational study included all patients initiating hemodialysis with central venous double-lumen catheters. Results: During the study, 240 catheters were inserted in 240 patients. A total of 48/240 (20%) developed CRBSI with 41/48 (85.4%) having culture-positive probable CRBSI and 07/48 (14.6%) having culture-negative possible CRBSI. Concomitant exit site infection was present in 09/48 (18.8%). The CRBSI incidence rate was 1.46 episodes per 1000 catheter days, based on 48 episodes over 32,782 catheter days. The mean time to CRBSI was 204.6 ± 87.1 days. Gram-positive bacteria were cultured in 15 cases (31.3%), Gram-negative bacteria in 26 cases (54.2%), and 7 cases (14.6%) had negative culture. Coagulase negative Staphylococcus Aureus (CoNS) was the most common Gram-positive pathogens isolated, making up 46.7% of the cases. Klebsiella pneumonia, Pseudomonas, and Acinetobacter species were identified as the most prevalent Gram-negative pathogens (n = 06/26 each; 23.1%. Among 8 cultured Gram-negative bacterial species, resistance patterns observed was Ampicillin: 4/4 tested (100.0%), Quinolones: 4/6 tested (66.7%), Clotrimazole: 3/5 tested (60.0%), Carbapenems: 3/6 tested (50.0%), Gentamicin: 2/5 tested (40.0%), Amikacin: 1/3 tested (33.3%), and Piperacillin-Tazobactam: 1/5 tested (20.0%). A total of 39/48 catheters were salvaged. Conclusions: CRBSI remains a significant issue in patients using central venous catheters. The rise of multidrug-resistant Gram-negative infections necessitates stricter measures, including improved hygiene, surveillance and long-term vascular access. Proper cultures should precede empirical antibiotic therapy, and healthcare centers should tailor their antibiotic policies to local susceptibility patterns.https://jrenhep.com/index.php/jrenhep/article/view/211/358catheter related blood stream infectioncuffed dialysis catheterun-cuffed dialysis catheterhemodialysis
spellingShingle Mohammad Bhat
Danish Muqbool
Rayees Yousuf
Manzoor Parry
Amir Farooq
Muzamil Wani
Imran Khan
Imtiyaz Wani
Muzafar Wani
Emergence of antibiotic resistance in bloodstream infections associated with catheters in hemodialysis patients: a prospective observational study
Journal of Renal and Hepatic Disorders
catheter related blood stream infection
cuffed dialysis catheter
un-cuffed dialysis catheter
hemodialysis
title Emergence of antibiotic resistance in bloodstream infections associated with catheters in hemodialysis patients: a prospective observational study
title_full Emergence of antibiotic resistance in bloodstream infections associated with catheters in hemodialysis patients: a prospective observational study
title_fullStr Emergence of antibiotic resistance in bloodstream infections associated with catheters in hemodialysis patients: a prospective observational study
title_full_unstemmed Emergence of antibiotic resistance in bloodstream infections associated with catheters in hemodialysis patients: a prospective observational study
title_short Emergence of antibiotic resistance in bloodstream infections associated with catheters in hemodialysis patients: a prospective observational study
title_sort emergence of antibiotic resistance in bloodstream infections associated with catheters in hemodialysis patients a prospective observational study
topic catheter related blood stream infection
cuffed dialysis catheter
un-cuffed dialysis catheter
hemodialysis
url https://jrenhep.com/index.php/jrenhep/article/view/211/358
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