Abstract | PURPOSE OF THE REVIEW: SOURCES OF INFORMATION: FINDINGS:
Bacterial infections in this setting are most commonly due to Gram-positive skin flora, particularly Staphylococcus, with methicillin-resistant Staphylococcus aureus (MRSA) carrying a poorer prognosis. Interventions that may decrease mortality from sepsis include a collaborative care model that includes a nephrology team, an infectious disease specialist, and use of standardized care bundles that adhere to proven quality-of-care indicators. Decreased infectious mortality may be achieved by ensuring appropriate antibiotic selection and dosing as well as avoiding catheter salvage attempts. Reduction in bloodstream infection (BSI) incidence has been observed with the use of tPA catheter-locking solutions and the use of mupirocin or polysporin as a topical agent at the catheter exit site, as well as implementing standarized hygiene protocols during catheter use. LIMITATIONS: There has been a paucity of randomized controlled trials of prevention and treatment strategies for catheter-related BSIs in haemodialysis. Some past trials have been limited by lack of blinding and short duration of follow-up. Microbiological epidemiology, although well characterized, may vary by region and treatment centre. IMPLICATIONS: With the high prevalence of catheter use in Canadian haemodialysis units, further studies on long-term treatment and preventative strategies for BSI are warranted.
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Authors | Chris Lata, Louis Girard, Michael Parkins, Matthew T James |
Journal | Canadian journal of kidney health and disease
(Can J Kidney Health Dis)
Vol. 3
Pg. 24
( 2016)
ISSN: 2054-3581 [Print] England |
PMID | 27152201
(Publication Type: Journal Article, Review)
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