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Hajji M, Neji M, Agrebi S, Nessira SB, Hamida FB, Barbouch S, Harzallah A, Abderrahim E. Incidence and challenges in management of hemodialysis catheter-related infections. Sci Rep 2022; 12:20536. [PMID: 36446808 PMCID: PMC9709051 DOI: 10.1038/s41598-022-23787-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/04/2022] [Indexed: 11/30/2022] Open
Abstract
Catheter-related infections (CRI) are a major cause of morbidity and mortality in chronic hemodialysis (HD) patients. In this paper, we share our experience with CRI in HD patients. We recorded 49 cases of CRI among 167 patients during a period of 40 months (January 2018-April 2021). The incidence of CRI was 3.7 per 1000 catheter-days. The revealing symptoms were dominated by fever or chills (90%). Inflammatory signs were observed in 74% of cases with respectively concurrent exit-site (51%) and tunnel infection (6%). The biological inflammatory syndrome was found in 74% of patients (average CRP level = 198.9 mg/l). Blood cultures were performed in all cases and were positive in 65% of cases. Thirteen patients have been diagnosed with Infection complications, which were respectively infective endocarditis in 7 cases, septic arthritis in 3 cases, infective myositis in one case, cerebral thrombophlebitis in 1 case and mediastinitis in 1 case. The death occurred in eleven patients, it was due to septic shock in 9 cases, pulmonary embolism in one case and neurologic alterations related to cerebral thrombophlebitis. The mean seniority in HD was 16.5 months in the group with CRI and 3.7 months in the group without CRI (p < 0.04). We did not notice significant difference in mortality between tunnelled and non-tunnelled catheters. CRI does not seem to be more severe in patients with diabetes. Duration of use of the HD catheter (p < 0.007) and ferritin level (p < 0.0001) were independent factors that predispose to CRI in our population.
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Affiliation(s)
- Meriam Hajji
- grid.413827.b0000 0004 0594 6356Department of Internal Medicine “A”, Charles Nicolle Hospital, Beb Saadoun, 1009 Tunis, Tunisie ,grid.12574.350000000122959819Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia ,grid.413827.b0000 0004 0594 6356Laboratory of Renal Pathology (LR00SP01), Charles Nicolle Hospital, Tunis, Tunisia
| | - Manel Neji
- grid.413827.b0000 0004 0594 6356Department of Internal Medicine “A”, Charles Nicolle Hospital, Beb Saadoun, 1009 Tunis, Tunisie ,grid.12574.350000000122959819Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Sahar Agrebi
- grid.413827.b0000 0004 0594 6356Department of Internal Medicine “A”, Charles Nicolle Hospital, Beb Saadoun, 1009 Tunis, Tunisie ,grid.12574.350000000122959819Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia ,grid.413827.b0000 0004 0594 6356Laboratory of Renal Pathology (LR00SP01), Charles Nicolle Hospital, Tunis, Tunisia
| | - Saoussen Ben Nessira
- grid.413827.b0000 0004 0594 6356Department of Internal Medicine “A”, Charles Nicolle Hospital, Beb Saadoun, 1009 Tunis, Tunisie ,grid.12574.350000000122959819Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Fethi Ben Hamida
- grid.413827.b0000 0004 0594 6356Department of Internal Medicine “A”, Charles Nicolle Hospital, Beb Saadoun, 1009 Tunis, Tunisie ,grid.12574.350000000122959819Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia ,grid.413827.b0000 0004 0594 6356Laboratory of Renal Pathology (LR00SP01), Charles Nicolle Hospital, Tunis, Tunisia
| | - Samia Barbouch
- grid.413827.b0000 0004 0594 6356Department of Internal Medicine “A”, Charles Nicolle Hospital, Beb Saadoun, 1009 Tunis, Tunisie ,grid.12574.350000000122959819Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia ,grid.413827.b0000 0004 0594 6356Laboratory of Renal Pathology (LR00SP01), Charles Nicolle Hospital, Tunis, Tunisia
| | - Amel Harzallah
- grid.413827.b0000 0004 0594 6356Department of Internal Medicine “A”, Charles Nicolle Hospital, Beb Saadoun, 1009 Tunis, Tunisie ,grid.12574.350000000122959819Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia ,grid.413827.b0000 0004 0594 6356Laboratory of Renal Pathology (LR00SP01), Charles Nicolle Hospital, Tunis, Tunisia
| | - Ezzedine Abderrahim
- grid.413827.b0000 0004 0594 6356Department of Internal Medicine “A”, Charles Nicolle Hospital, Beb Saadoun, 1009 Tunis, Tunisie ,grid.12574.350000000122959819Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
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Olmos C, Vilacosta I, Sarriá C, Fernández C, López J, Ferrera C, Vivas D, Hernández M, Sánchez-Enrique C, Ortiz C, Maroto L, San Román JA. Characterization and clinical outcome of patients with possible infective endocarditis. Int J Cardiol 2014; 178:31-3. [PMID: 25464213 DOI: 10.1016/j.ijcard.2014.10.171] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Accepted: 10/27/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Carmen Olmos
- Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain.
| | - Isidre Vilacosta
- Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain
| | - Cristina Sarriá
- Servicio de Medicina Interna-Infecciosas, Instituto de Investigación Sanitaria del Hospital Universitario de la Princesa, Madrid, Spain
| | | | - Javier López
- Instituto de Ciencias del Corazón (ICICOR), Hospital Universitario de Valladolid, Valladolid, Spain
| | - Carlos Ferrera
- Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain
| | - David Vivas
- Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain
| | - Miguel Hernández
- Servicio de Medicina Interna-Infecciosas, Instituto de Investigación Sanitaria del Hospital Universitario de la Princesa, Madrid, Spain
| | | | - Carlos Ortiz
- Instituto de Ciencias del Corazón (ICICOR), Hospital Universitario de Valladolid, Valladolid, Spain
| | - Luis Maroto
- Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain
| | - José Alberto San Román
- Instituto de Ciencias del Corazón (ICICOR), Hospital Universitario de Valladolid, Valladolid, Spain
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Lima JK, Lima SR, de Lima Jr A, Agra CV, Valenti V, Gomes R, Rodrigues L, Correa J, Raimundo RD, de Abreu L. Double-lumen catheter in the right jugular vein induces two sub-endothelial abscesses in an unusual place, the transition between the superior vena cava and the right atrium: a case report. Int Arch Med 2014; 7:37. [PMID: 25110520 PMCID: PMC4125593 DOI: 10.1186/1755-7682-7-37] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Accepted: 05/12/2014] [Indexed: 11/10/2022] Open
Abstract
Endocarditis is a type of infection that is common in internal medicine wards and in haemodialysis clinics. The location that is most affected are the heart valves. Herein, we report a case of an uncommon abscess, a sub-endothelial abscess between the transition of the superior vena cava and the right atrium. There were several emboli to the lung and foot, and the agent was related to Staphylococcus aureus and a double-lumen catheter. Usually, this type of abscess is located in valves, either the tricuspid valve if related to catheters or injection drug use or the mitral valve if related to other causes. An exhaustive review was made, but we found no information about the location of this abscess and the rarity of the event motivating the report of infection.
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