Tunneled Catheter-Related Bloodstream Infections in Chronic Hemodialysis Patients: Frequency, Risk Factors, and Outcomes-A 10-Year Analysis

Abstract

The aim of this study is to investigate the rate, risk factors, causative microorganism distribution, and treatment outcomes of catheter-related bloodstream infection (CRBSI) in chronic hemodialysis patients undergoing treatment with a tunneled hemodialysis catheter. Data for all patients who underwent hemodialysis treatment with tunneled catheters at our center between January 2014 and January 2024 were retrospectively analyzed. A total of 171 patients were included in the study. Forty-five patients had 54 CRBSI episodes. The average time between catheter placement and the development of CRBSI was 127.4 days, and the risk of developing CRBSI increased as this duration extended. In the bivariate logistic regression analysis, advanced age (p = 0.03), diabetes (p = 0.005), duration of hemodialysis (p < 0.001), decompensated cirrhosis (p = 0.02), and the femoral vein being the entry site (p = 0.011) were identified as risk factors for CRBSI. In the ROC analysis, the hemoglobin A1c threshold value for the development of CRBSI in diabetic patients was determined to be 9.350 (69% sensitivity, 87% specificity, AUC = 0.755, p < 0.001). We believe that avoiding femoral vein catheterization as much as possible and expediting the transition from catheter to another method for dialysis are important measures to prevent the development of CRBSI.