345 Acta Clinica Belgica, 2003; 58-6 CENTRAL VEIN HEMODIALYSIS CATHETERS AND INFECTION: A PLEA FOR TIMELY REFERRAL AND APPROPRIATE HYGIENIC MEASURES TEMPORARY CATHETER INFECTIONS IN HEMODIALYSIS PATIENTS Results from a single center in Turkey M. R. Altıparmak¹, K. Güngör², G. E. Pamuk 3 , Ö. N. Pamuk 3 , R. Özgenç², R. Öztürk². Key-words: Catheter exit-site infection (CESI), catheter-related infection (CRI), catheter-related bloodstream infection (CR-BSI), hemodialysis, temporary catheters. ––––––––––––––– 1 Istanbul Üniversitesi Cerrahpas Tıp Fakültesi, Nefroloji Bilim Dalı, Istanbul-TURKEY. 2 Istanbul Üniversitesi Cerrahpas¸a Tıp Fakültesi, Klinik Bakteriyoloji ve Enfeksiyon Hastalıkları Anabilim Dalı, Istanbul-TURKEY. 3 Istanbul Üniversitesi Cerrahpas¸a Tıp Fakültesi, Iç Hastalıkları Anabilim Dalı, Istanbul-TURKEY. Address for correspondence : Dr. Mehmet Rıza Altıparmak Rasimpas¸a Mah., Tas¸lıbayır Sok., No: 14, Daire: 10 Kadıköy – Istanbul, TURKEY. Telephone: +90 216 348 49 23 E-mail: gepamuk@yahoo.com Original articles ABSTRACT In this study, we aimed to determine the frequencies of catheter exit-site infection (CESI), catheter-related bloodstream infection (CR-BSI) and catheter coloni- zation (CC); causative microorganisms; and resistance patterns in patients with temporary hemodialysis cathe- ters. From March 1999 to March 2000, 67 hemodialysis patients (38 males, 29 females; median age: 52, range: 17-84) were evaluated. The CDC criteria were used to diagnose CESI, CR-BSI and CC. The tips of catheters were cultured by Maki’s method. At the same time, two different blood cultures, one from peripheral vein and the other through the catheter lumen were drawn. Swab cultures from the catheter exit sites were also performed. The isolation and identification of bacteria were per- formed by conventional methods and the susceptibility testing by the Kirby-Bauer method. CESI, CR-BSI and CC were found in, respectively, 20 (29.8%), 16 (23.8%) and 11 (16.4%) patients. The etiologic agents in CR-BSI were as follows: Staphylococcus aureus (5), coagulase- negative staphylococci (2), Enterococcus sp. (1), Esche- richia coli (1), Acinetobacter sp. (1) and Proteus sp. (1). Methicillin-resistant coagulase-negative staphylococci and methicillin-resistant S. aureus were found in propor- tions of 45.5% and 63.6% in CESI and CR-BSI+CC. The only risk factor for the development of CR-BSI and CC was intravenous drug use. In our center, the majority of CESI, CR-BSI and CC were due to staphylococci and there was a high rate of methicillin resistance. INTRODUCTION Central venous catheterization provides rapid, temporary access for hemodialysis (HD) and it is used quite frequently. A study performed in the USA in 1990 revealed that 73% of patients undergoing HD had been inserted one or more HD catheters (1). HD catheters might be divided into two types: temporary catheters and permanent catheters tunneled beneath the skin. Temporary HD catheters are usually used for less than a duration of 3 weeks. Chronic catheters are used in patients in whom there is no suitable AV fistula for vas- cular access or patients who are being prepared for renal transplantation or continuous peritoneal dialysis (2). Bacteremic infections are one of the major causes for mortality and morbidity in chronic renal failure patients undergoing HD (3). Dialysis catheters are a common 345-349 Temporary 345 20-01-2004, 12:37:33