# 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.

## Key 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.