SM Journal of Nephrology and Kidney Diseases Gr up SM How to cite this article Alfouzan W, Alkandari F, Yosri A, Azizieh F, Tawalah HA and Dhar R. Infections in Pediatric Dialysis Patients in Mubarak Al-Kabeer Hospital, Kuwait: 10 Year’s Experience. J Nephrol Kidney Dis. 2017; 1(3): 1010. https://dx.doi.org/10.36876/smjnkd.1010 OPEN ACCESS ISSN: 2576-5450 Introduction Te incidence of End-Stage Renal Disease (ESRD) has increased worldwide leading to advancements in dialysis care in order to improve the overall survival rate [1]. However, dialysis access, whether in Hemodialysis (HD) or Peritoneal Dialysis (PD), remains a challenge, especially in pediatric patients. Although dialysis access is the mainstay in ESRD management, it also represents a major source of morbidity for these patients while contributing signifcantly to health care costs. Infections are a signifcant, potentially modifable, contributor to access-related difculties. In general, infections represent the second leading cause of death in ESRD patients, behind only cardiovascular disease and are a leading cause of hospitalization [1-4]. Concerning PD, exit site infections and peritonitis remain the most common causes of treatment failure. Tis is largely due to the constant reserve of a dextrose-rich solution in the peritoneal space, which provides a high-risk environment for infection along with frequent daily access manipulation. HD, however, represent a fast and efcient correction of fuid and metabolic abnormalities, better oral intake of food and drugs, and eliminates the active participation of patient or family in the dialysis procedure. Tunneled cufed Central Venous Catheters (CVCs) inserted surgically, mostly into the superior vena cava, ofer long-term option for HD in the pediatric age group [2,3,5]. Te aim of this study was to measure the incidence rate and risk factors for the development of infection following HD or PD and examine the microbiological profle of common organisms causing dialysis-related infections. We retrospectively studied incidence of infection in pediatric patients undergoing dialysis at the dialysis center of Mubarak Al-Kabeer hospital in Kuwait from the time of its establishment in July 2003 to June 2013. Research Article Infections in Pediatric Dialysis Patients in Mubarak Al-Kabeer Hospital, Kuwait: 10 Year’s Experience Wadha Alfouzan 1,2 *, Faisal Alkandari 3 , Ayman Yosri 3 , Fawaz Azizieh 4 , Haya Al Tawalah 5 and Dhar R 2 1 Department of Microbiology, Kuwait University, Kuwait 2 Department of Laboratories, Farwania Hospital, Kuwait 3 Department of Pediatrics, Mubarak al-Kabeer hospital, Kuwait 4 Department of Mathematics and Natural Sciences, Gulf University for Science and Technology, Kuwait 5 Department of Laboratories, Mubarak al-Kabeer Hospital, Kuwait Article Information Received date: Dec 14, 2017 Accepted date: Dec 22, 2017 Published date: Dec 29, 2017 *Corresponding author Wadha Alfouzan, Department of Microbiology, Faculty of Medicine, Health Sciences Centre, Kuwait University, Kuwait, Tel: 965-24888000 (or) 965-99099222; Fax: 965-24893078; Email: alfouzan.w@hsc.edu.kw Distributed under Creative Commons CC-BY 4.0 Keywords Hemodialysis; Peritoneal dialysis; Dialysis-related infection; Pediatrics Article DOI 10.36876/smjnkd.1010 Abstract Objective: As the incidence of End Stage Renal Disease (ESRD) worldwide has increased, so has the need for performing Hemodialysis (HD) and Peritoneal Dialysis (PD). We sought to identify risk factors and measure the rate of infections in pediatric patients undergoing dialysis. Design: A retrospective study Setting: Single pediatric dialysis center in Kuwait from July 2003-July 2013 Subjects: Pediatric patients undergoing PD or HD Interventions: Follow up of risk factors and rate of infections incidents Main outcome measures: Risk factors, incidence rate of infections and microbiological profle of organisms causing dialysis-related infections were determined in HD or PD patients. Results: A total of 91 patients underwent HD and 63 patients underwent PD. The episodes of infection were documented in 13 patients in each of the two groups. Our rates of infection were found to be one peritonitis episode per 20 patient-months in PD group and 0.41 infection episodes per patient-year in HD group. The commonest organisms isolated in PD-related infections were Pseudomonas aeruginosa and Coagulase- Negative Staphylococci (CNST) whereas in HD-related infections CNST was the leading organism. Among the risk factors in both groups, personal hygiene was the most signifcant with a P-value of <0.05. Mortality related to infection was 7.7% in PD with a median follow up of 6 months and none was reported in HD. Conclusion: Our infection rates were consistent with international reports and consistent with others in proving poor personal hygiene as a signifcant risk factor for infection in patients undergoing renal dialysis.