Microorganisms and Mortality Factors in Hospitalized Hemodialysis Patients with Catheter-Related Bloodstream Infection and Infective Endocarditis: 7 Years of Experience

TL;DR

This study examines the types of infections and risk factors for death in hemodialysis patients with bloodstream infections and heart infections over seven years.

Contribution

The study identifies Staphylococcus aureus as a major pathogen and highlights age as a key mortality predictor in catheter-dependent hemodialysis patients.

Findings

Staphylococcus aureus was responsible for 35.3% of catheter-related bloodstream infections.

Infective endocarditis occurred in 9.4% of patients with catheter-related bloodstream infections.

Older age was the only independent predictor of 90-day mortality in these patients.

Abstract

Background and Objectives: Catheter-related bloodstream infections (CRBSIs) and infective endocarditis (IE) lead to substantial morbidity, prolonged hospitalizations, and increased mortality. This study aimed to determine the incidence of IE among hospitalized catheter-dependent HD patients with CRBSI and identify risk factors associated with 90-day all-cause mortality. Materials and Methods: We conducted a retrospective analysis of patients diagnosed with CRBSI. Clinical, microbiological, and accessible echocardiographic data were evaluated. Risk factors for 90-day mortality were analyzed using univariate analysis and multivariable binary logistic regression analysis models. Results: A total of 85 hospitalized catheter-dependent HD patients with CRBSI were included. Gram-positive organisms were the predominant pathogens (70.6%), with Staphylococcus aureus identified in 35.3% (30/85) of all CRBSI cases. Gram-negative bacteria accounted for 29.4% of all CRBSIs. IE was identified in 9.4% (n = 8) of patients diagnosed with CRBSI. Significant differences were observed between the IE and non-IE groups regarding the need for length of hospital stay, vegetation, embolism (p < 0.05). The 90-day all-cause mortality rate was 14.1% (n = 12). Univariate analysis identified that older age and female gender were associated with increased mortality (p < 0.05). In the multivariable binary logistic regression, only age (OR: 1.055, 95% CI: 1.005–1.107, p = 0.029) remained an independent predictor of 90-day mortality. Conclusions: In catheter-dependent HD patients, Staphylococcus aureus is the predominant organism associated with both CRBSI and IE. With an observed IE occurring in 9.4% hospitalized catheter-dependent HD patients with CRBSI, consistent compliance with prevention bundles must be prioritized as a standard of care for catheter management.

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