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Subclavian hemodialysis catheter infections
Authors:P J Dahlberg  W R Yutuc  K L Newcomer
Institution:2. Department of Neurosurgery, Nara Medical University, Nara, Japan;1. Unité Clinique d''Hémostase et de Thrombose, CHU Dijon Bourgogne, Dijon, France;2. Direction de la Recherche Clinique et de l''Innovation (DRCI), Unité de Soutien Méthodologique à la Recherche (USMR), CHU Dijon Bourgogne, Dijon, France;3. Service de Médecine Intensive-Réanimation, CHRU Strasbourg, Faculté de Médecine, Strasbourg, France;4. INSERM Centre d''Investigation Clinique-Epidemiologie Clinique (CIC-EC 1432), Université Bourgogne-Franche-Comté, Dijon, France;5. Service de Médecine Intensive-Réanimation, CHU Dijon Bourgogne, France;6. Lipness Team, INSERM Research Centre LNC-UMR1231 and LabEx LipSTIC, Université Bourgogne-Franche-Comté, Dijon, France;7. Pharmacie, CHU Dijon Bourgogne, Dijon, France;8. INSERM Centre de Recherche LNC-UMR1231, Université Bourgogne-Franche-Comté, Dijon, France;9. INSERM UMR 1260, Regenerative Nanomedicine, FMTS, Strasbourg, France;10. ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Fédération Hospitalo-Universitaire OMICARE, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France
Abstract:One hundred sixteen subclavian hemodialysis catheter placements in 88 patients were prospectively evaluated for catheter-related infections. Semiquantitative culture techniques and a rigid infection control protocol were used. The overall catheter colonization rate was 21.6% and catheter-associated bacteremia occurred in 9.4%. Catheters removed from febrile patients had much higher colonization (48.3%) and bacteremia (34.5%) rates. In a randomized study comparing infection rates in catheters tunneled subcutaneously or not tunneled, there was no significant difference in the incidence of infection. Catheters inserted over a guidewire to replace clotted or malfunctioning catheters were not associated with higher infection rates.
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