Análisis de la influencia de la pandemia por el virus SARS-CoV-2 sobre la tasa de bacteriemia en catéteres venosos tunelizados en una unidad de hemodiálisis

Verónica Gimeno-Hernán; José Antonio Herrero-Calvo; Araceli Faraldo-Cabaña; Ignacio Zaragoza-García; María del Rosario del Pino-Jurado; Ismael Ortuño-Soriano

doi:10.37551/S2254-28842023009

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December 22, 2022

Published

March 30, 2023

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Abstract

Background: Central venous catheter (CVC) related infection is associated with high morbidity and mortality. It has also been linked to CVC-associated bacteremia, catheter dysfunctions, as well as handling and hygienic measures taken during that time.

Objective: The aim of the present study is to compare the bacteremia rate between 2019 and 2020, the last one during which the SARS-CoV-2 virus pandemic started. The study was accomplished in a hemodialysis unit at the Comunidad Autonoma de Madrid hospital.

Material and Method: An observational retrospective cross-sectional study has been carried out in which data related to the management and functioning of the catheter were compared to the bacteremia rate linked to the catheter between 2019 and 2020 through the unit’s database.

Results: In 2019, thirty-five patients were included, who had a bacteraemia rate of 1.42/1000 catheter days, and twenty-nine patients in 2020, with a bacteraemia rate of 1.82/1000 catheter days, finding no significant differences (p=0.54), as well as not finding an increased or decreased bacteremia risk during the first year of the pandemic caused by the SARS-CoV-2 virus.

Conclusions: As the main conclusion of this case of study, we are able to confirm that there is no evidence of the coronavirus pandemic and the measures adopted against the SARS-CoV-2 virus (both organizational and preventives), being a risk or protection factor in regard to the bacteraemia rate, most likely due to the low number of events found.

Keywords

central venous catheter bacteremia nursing; care hemodialysis SARS-CoV-2.

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How to Cite

1.

Gimeno-Hernán V, Herrero-Calvo JA, Faraldo-Cabaña A, Zaragoza-García I, del Pino-Jurado M del R, Ortuño-Soriano I. Analysis of the influence of the SARS-CoV-2 virus pandemic on the bacteriemia rate in tunneled venous catheters in a hemodialysis unit. Enferm Nefrol [Internet]. 2023 [cited 2025 Apr 30];26(1):[about 7 p.]. Available from: https://www.enfermerianefrologica.com/revista/article/view/4533

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References

Allon M. Dialysis catheter-related bacteremia: treatment and prophylaxis. Am J Kidney Dis 2004;44:779.
Feely T, Copley A, Bleyer AJ. Catheter lock solutions to prevent bloodstream infections in high-risk hemodialysis patients. Am J Nephrol 2007;27:24-9.
Fariñas, M. C., García-Palomo, J. D., & Gutiérrez-Cuadra, M. Infecciones asociadas a los catéteres utilizados para la hemodiálisis y la diálisis peritoneal. Enfermedades infecciosas y microbiología clínica 2008;26(8),518-26.
Taylor G, Gravel D, Johnston L, Embil J, Holton D, Paton S. Incidence of bloodstream infection in multicenter infection cohorts of hemodialysis patients. Canadian Nosocomial Infection Surveillance Program, Canadian Hospital Epidemiology Committee. Am J Infect Control 2004;32:155.
Vats HS. Complications of catheteres: tunneled and non tunneled. Adv Chronic Kidney Dis 2012; 19(3):188-94.
Albalate M, Perez R, De Sequera P, Alcázar R, Puerta M, Ortega M, et al. ¿Hemos olvidado lo más importante para prevenir las bacteriemias en pacientes portadores de catéter para HD?. Nefrología 2010;3:573-7.
Arribas P. Prevalencia de bacteriemias relacionadas con el catéter de hemodiálisis en una unidad hospitalaria. Enferm Nefrol 2013;16:229-34.
Mokrzycki MH, Zhang M, Cohen H, Golestaneh L, Laut JM, Rosenberg SO. Tunnelled haemodialysis catheter bacteraemia: Risk factors for bacteraemia recurrence, infectious complications and mortality. 2006. Nephrol Dial Transplant 2006;21:1024–35.
Zhang HH, Cortes-Penfield NW, Mandayam S, Niu J, Atmar RL, Wu E, et al. Dialysis Catheter-related Bloodstream Infections in Patients Receiving Hemodialysis on an Emergency-only Basis: A Retrospective Cohort Analysis. Clin Infect Dis 2019;68(6):1011-6.
Soi V, Moore CL, Kumbar L, Yee J. Prevention of catheter-related bloodstream infections in patients on hemodialysis: challenges and management strategies. Int J Nephrol Renovasc Dis 2016;9:95-103.
Ibeas J, Roca-Tey R, Vallespín J, Moreno T, Moñux G, Martí-Monrós A, et al. Guía Clínica Española del Acceso Vascular para Hemodiálisis. Nefrología 2017;37:1-193
Crespo María, Ruiz MC, Gómez M, Crespo R. Las bacteriemias relacionadas con el catéter tunelizado de hemodiálisis y cuidados de enfermería. Enferm Nefrol 2017; 20(4):353-65.
Concepcion D, Felizardo G, Moran J, Peters V, Shapiro S, Yu M. Guide to the Elimination of Infections in Hemodialysis. Infection Control 2009;1-58.
Centros para el Control y la Prevención de Enfermedades. Core Intervenciones [Internet]. Georgia: Departamento de Salud y Servicios Humanos de los Estados Unidos. [consultado 18 Oct 2020]. Disponible en: https://www.cdc.gov/dialysis/prevention-tools/core-interventions.html.
Schweiger A, Trevino S, Marschall J. Nosocomial infections in dialysis access. Contrib Nephrol 2015;184:205-21.
Valeri AM, Robbins-Juárez SY, Stevens JS, Ahn W, Rao MK, Radhakrishnan J, et al. Presentation and Outcomes of Patients with ESKD and COVID-19. JASN [Internet]. 2020 [consultado 8 Feb 2022]; 31(7):1409-15. Disponible en: https://jasn.asnjournals.org/lookup/doi/10.1681/ASN.2020040470.
Who.int. [Internet]. [consultado 20 Ene 2023]. Disponible en: https://apps.who.int/iris/bitstream/handle/10665/356895/WHO-2019-nCoV-Policy-brief-IPC-HCF-2022.1-spa.pdf.
Arenas MD, Villar J, González C, Cao H, Collado S, Crespo M, et al. Manejo de la epidemia por coronavirus SARS-CoV-2 (COVID-19) en unidades de hemodiálisis. Nefrología [Internet]. 2020 [consultado 14 Mar 2022]; 40(3):258-64. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S0211699520300394.
Beathard GA, Urbanes A. Infection associated with tunneled hemodialysis catheters. Semin Dial 2008;21(6):528-38.
NFK/DOQI. Clinical Practice Guidelines for Vascular Access. Am J Kidney Dis 2006;48 (Suppl 1):S176-273.
Besarab A, Pandey R. Catheter management in hemodialysis patients: delivering adequate flow. Clin J Am Soc Nephrol 2011;6:227-34.
Roca-Tey R, Samon R, Ibrik O, Roda A, González-Oliva JC, Martínez-Cercós R, et al. Incidence and etiology of vascular access (VA) thrombosis in prevalent patients under VA surveillance for stenosis by blood flow rate (QA) measurements. Nephrol Dial Transplant 2012;27(Suppl 2):S257.
Centers for M, Medicaid Services HHS. Medicare Program; end stage renal disease prospective Payment system, Payment for renal dialysis Services Furnished to Individuals with Acute kidney Injury, and end-stage renal disease Quality Incentive Program. Final rule. Fed Regist 2017;82(210):50738-97.
Nicole AG, Tronchin DMR. Indicadores para avaliação do acesso vascular de usuários em hemodiálise. Rev Esc Enferm USP 2011;45(1):206-14.
Informe del Registro Madrileño de Enfermos Renales Informe del Registro de Enfermos Renales de Madrid. 2021 [Internet]. [consultado 23 Ene 2023]. Disponible en: https://www.comunidad.madrid/sites/default/files/doc/sanidad/asis/informe_remer_2021.pdf.
Fundación Renal Iñigo Álvarez de Toledo. 2019 [Internet]. [consultado 20 Ene 2023]. Disponible en: https://fundacionrenal.com/contenido/libros/memoria2019.pdf.
García P, Payá E, Olivares R, Cotera A, Rodríguez J, Sanz M. Diagnóstico de las infecciones asociadas a catéteres vasculares centrales. Rev Chil Infect 2003;20(1):41-50.
Miler LM, Clark E, Dipchand C, Hiremath S, Kappel J, Kiaii M, et al. Hemodialysis Tunneled Catheter-Related Infections. Can J Kidney Health Dis 2016;27:1-11.
Beathard GA, Urbanes A. Infection associated with tunneled hemodialysis catheters. Semin Dial 2008;21(6):528-38.
Kliger AS, Garrick R: Evidence-based practices to reduce COVID-19 transmission in dialysis facilities. Clin J Am Soc Nephrol 2021;16(8):1146-8.
Heidempergher M, Sabiu G, Orani MA, Tripeppi G, Gallieni M. Targeting COVID‑19 prevention in hemodialysis facilities is associated with a drastic reduction in central venous catheter‑related infections. J Nephrol. 2021;34:345-53.
Crehuet Rodríguez I, Bernárdez Lemus MA, Ramírez Crehuet M, Méndez Briso-Montiano P, Ruiz-Zorrilla López C. Bioconectores: ¿Son realmente eficaces en la prevención de las bacteriemias relacionadas con el catéter permanente para hemodiálisis? Rev Soc Esp Enferm Nefrol 2013;16(4):235-40.
Alcalde-Bezhold G, Alcázar-Arroyo R, Angoso-de-Guzmán M, Arenas MD, Arias-Guillén M, Arribas-Cobo P, et al. Guía de unidades de hemodiálisis 2020. Nefrología 2021;41:1-77.
Cárcamo Baena J, Salgueira Lazo M, Gómez Castilla C, Rodríguez Pérez MA, Tienda Moreno M, Rico Castillo C, et al. Modelo de manejo multidisciplinar de catéteres permanentes tunelizados: resultados a 5 años. Rev Soc Esp Enferm Nefrol 2012;15(2):138-44.
Aslam S, Vaida F, Ritter M, Metha RL. Systematic Review and Meta-Analysis on Management of Hemodialysis Catheter-Related Bacteremia. J Am Soc Nephrol 2014;25:1-15.

References

Allon M. Dialysis catheter-related bacteremia: treatment and prophylaxis. Am J Kidney Dis 2004;44:779.

Feely T, Copley A, Bleyer AJ. Catheter lock solutions to prevent bloodstream infections in high-risk hemodialysis patients. Am J Nephrol 2007;27:24-9.

Fariñas, M. C., García-Palomo, J. D., & Gutiérrez-Cuadra, M. Infecciones asociadas a los catéteres utilizados para la hemodiálisis y la diálisis peritoneal. Enfermedades infecciosas y microbiología clínica 2008;26(8),518-26.

Taylor G, Gravel D, Johnston L, Embil J, Holton D, Paton S. Incidence of bloodstream infection in multicenter infection cohorts of hemodialysis patients. Canadian Nosocomial Infection Surveillance Program, Canadian Hospital Epidemiology Committee. Am J Infect Control 2004;32:155.

Vats HS. Complications of catheteres: tunneled and non tunneled. Adv Chronic Kidney Dis 2012; 19(3):188-94.

Albalate M, Perez R, De Sequera P, Alcázar R, Puerta M, Ortega M, et al. ¿Hemos olvidado lo más importante para prevenir las bacteriemias en pacientes portadores de catéter para HD?. Nefrología 2010;3:573-7.

Arribas P. Prevalencia de bacteriemias relacionadas con el catéter de hemodiálisis en una unidad hospitalaria. Enferm Nefrol 2013;16:229-34.

Mokrzycki MH, Zhang M, Cohen H, Golestaneh L, Laut JM, Rosenberg SO. Tunnelled haemodialysis catheter bacteraemia: Risk factors for bacteraemia recurrence, infectious complications and mortality. 2006. Nephrol Dial Transplant 2006;21:1024–35.

Zhang HH, Cortes-Penfield NW, Mandayam S, Niu J, Atmar RL, Wu E, et al. Dialysis Catheter-related Bloodstream Infections in Patients Receiving Hemodialysis on an Emergency-only Basis: A Retrospective Cohort Analysis. Clin Infect Dis 2019;68(6):1011-6.

Soi V, Moore CL, Kumbar L, Yee J. Prevention of catheter-related bloodstream infections in patients on hemodialysis: challenges and management strategies. Int J Nephrol Renovasc Dis 2016;9:95-103.

Ibeas J, Roca-Tey R, Vallespín J, Moreno T, Moñux G, Martí-Monrós A, et al. Guía Clínica Española del Acceso Vascular para Hemodiálisis. Nefrología 2017;37:1-193

Crespo María, Ruiz MC, Gómez M, Crespo R. Las bacteriemias relacionadas con el catéter tunelizado de hemodiálisis y cuidados de enfermería. Enferm Nefrol 2017; 20(4):353-65.

Concepcion D, Felizardo G, Moran J, Peters V, Shapiro S, Yu M. Guide to the Elimination of Infections in Hemodialysis. Infection Control 2009;1-58.

Centros para el Control y la Prevención de Enfermedades. Core Intervenciones [Internet]. Georgia: Departamento de Salud y Servicios Humanos de los Estados Unidos. [consultado 18 Oct 2020]. Disponible en: https://www.cdc.gov/dialysis/prevention-tools/core-interventions.html.

Schweiger A, Trevino S, Marschall J. Nosocomial infections in dialysis access. Contrib Nephrol 2015;184:205-21.

Valeri AM, Robbins-Juárez SY, Stevens JS, Ahn W, Rao MK, Radhakrishnan J, et al. Presentation and Outcomes of Patients with ESKD and COVID-19. JASN [Internet]. 2020 [consultado 8 Feb 2022]; 31(7):1409-15. Disponible en: https://jasn.asnjournals.org/lookup/doi/10.1681/ASN.2020040470.

Who.int. [Internet]. [consultado 20 Ene 2023]. Disponible en: https://apps.who.int/iris/bitstream/handle/10665/356895/WHO-2019-nCoV-Policy-brief-IPC-HCF-2022.1-spa.pdf.

Arenas MD, Villar J, González C, Cao H, Collado S, Crespo M, et al. Manejo de la epidemia por coronavirus SARS-CoV-2 (COVID-19) en unidades de hemodiálisis. Nefrología [Internet]. 2020 [consultado 14 Mar 2022]; 40(3):258-64. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S0211699520300394.

Beathard GA, Urbanes A. Infection associated with tunneled hemodialysis catheters. Semin Dial 2008;21(6):528-38.

NFK/DOQI. Clinical Practice Guidelines for Vascular Access. Am J Kidney Dis 2006;48 (Suppl 1):S176-273.

Besarab A, Pandey R. Catheter management in hemodialysis patients: delivering adequate flow. Clin J Am Soc Nephrol 2011;6:227-34.

Roca-Tey R, Samon R, Ibrik O, Roda A, González-Oliva JC, Martínez-Cercós R, et al. Incidence and etiology of vascular access (VA) thrombosis in prevalent patients under VA surveillance for stenosis by blood flow rate (QA) measurements. Nephrol Dial Transplant 2012;27(Suppl 2):S257.

Centers for M, Medicaid Services HHS. Medicare Program; end stage renal disease prospective Payment system, Payment for renal dialysis Services Furnished to Individuals with Acute kidney Injury, and end-stage renal disease Quality Incentive Program. Final rule. Fed Regist 2017;82(210):50738-97.

Nicole AG, Tronchin DMR. Indicadores para avaliação do acesso vascular de usuários em hemodiálise. Rev Esc Enferm USP 2011;45(1):206-14.

Informe del Registro Madrileño de Enfermos Renales Informe del Registro de Enfermos Renales de Madrid. 2021 [Internet]. [consultado 23 Ene 2023]. Disponible en: https://www.comunidad.madrid/sites/default/files/doc/sanidad/asis/informe_remer_2021.pdf.

Fundación Renal Iñigo Álvarez de Toledo. 2019 [Internet]. [consultado 20 Ene 2023]. Disponible en: https://fundacionrenal.com/contenido/libros/memoria2019.pdf.

García P, Payá E, Olivares R, Cotera A, Rodríguez J, Sanz M. Diagnóstico de las infecciones asociadas a catéteres vasculares centrales. Rev Chil Infect 2003;20(1):41-50.

Miler LM, Clark E, Dipchand C, Hiremath S, Kappel J, Kiaii M, et al. Hemodialysis Tunneled Catheter-Related Infections. Can J Kidney Health Dis 2016;27:1-11.

Beathard GA, Urbanes A. Infection associated with tunneled hemodialysis catheters. Semin Dial 2008;21(6):528-38.

Kliger AS, Garrick R: Evidence-based practices to reduce COVID-19 transmission in dialysis facilities. Clin J Am Soc Nephrol 2021;16(8):1146-8.

Heidempergher M, Sabiu G, Orani MA, Tripeppi G, Gallieni M. Targeting COVID‑19 prevention in hemodialysis facilities is associated with a drastic reduction in central venous catheter‑related infections. J Nephrol. 2021;34:345-53.

Crehuet Rodríguez I, Bernárdez Lemus MA, Ramírez Crehuet M, Méndez Briso-Montiano P, Ruiz-Zorrilla López C. Bioconectores: ¿Son realmente eficaces en la prevención de las bacteriemias relacionadas con el catéter permanente para hemodiálisis? Rev Soc Esp Enferm Nefrol 2013;16(4):235-40.

Alcalde-Bezhold G, Alcázar-Arroyo R, Angoso-de-Guzmán M, Arenas MD, Arias-Guillén M, Arribas-Cobo P, et al. Guía de unidades de hemodiálisis 2020. Nefrología 2021;41:1-77.

Cárcamo Baena J, Salgueira Lazo M, Gómez Castilla C, Rodríguez Pérez MA, Tienda Moreno M, Rico Castillo C, et al. Modelo de manejo multidisciplinar de catéteres permanentes tunelizados: resultados a 5 años. Rev Soc Esp Enferm Nefrol 2012;15(2):138-44.

Aslam S, Vaida F, Ritter M, Metha RL. Systematic Review and Meta-Analysis on Management of Hemodialysis Catheter-Related Bacteremia. J Am Soc Nephrol 2014;25:1-15.