Journal Article

Burden of Infection in Patients with End-Stage Renal Disease Requiring Long-Term Dialysis

Steven J. Berman, E. William Johnson, Curtis Nakatsu, Michael Alkan, Randi Chen and Jean LeDuc

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 39, issue 12, pages 1747-1753
Published in print December 2004 | ISSN: 1058-4838
Published online December 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/424516
Burden of Infection in Patients with End-Stage Renal Disease Requiring Long-Term Dialysis

More Like This

Show all results sharing these subjects:

  • Infectious Diseases
  • Immunology
  • Public Health and Epidemiology
  • Microbiology

GO

Show Summary Details

Preview

Background. This study examines the spectrum of infections in a selected population of patients requiring long-term dialysis, enlarging the focus beyond infections associated with the dialysis process.

Methods. Infection data were reviewed from complete archived inpatient and outpatient dialysis records of 433 patients who were treated at a single hospital-based dialysis program and its dialysis satellites over a 9-year period, from 1 January 1992 to 31 December 2000.

Results. The study period included 424,700 days of dialysis experience. A total of 2412 episodes of bacterial or fungal infections were treated in 433 patients. The infection rate was 5.7 episodes per 1000 days of dialysis. Patients received 5111 courses of antibiotics over 42,627 days of treatment, which cumulatively accounted for 10% of the total days of the study. Infections associated with hemodialysis vascular access devices comprised 20.5% of the total episodes. Infections below the knee (19.3% of infection episodes), pneumonia (13%), and other skin and soft-tissue infections (9%) were also important types and sources of infection, accounting for >42% of the total episodes. Eighty-two percent of the infections (1971 episodes) were acquired in the community. Of these, 868 (44%) required hospitalization. An additional 441 episodes were nosocomial. The profile of bacteria isolated from patients with community-acquired infections mirrored that of bacteria recovered from patients with nosocomial infections.

Conclusion. Patients with end-stage renal disease have an enormous burden of infection. The majority of the infections are unrelated to dialysis. Frequent and long-term antibiotic use and cohorting of patients in the dialysis unit have altered the microbiological flora of such individuals, with clinical and epidemiological implications.

Journal Article.  3728 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.