Hemodialysis Catheter-Related Infection: Prevalence, Clinical Risk Factors and Mortality Rate in North-West of Iran

Abstract

Background: Catheter-related bloodstream infection (CRBI) is a prevalent bacterial complication that can lead to severe outcomes, including cardiovascular diseases, cerebrovascular disorders, and increased mortality rates if untreated. Objectives: The present study aimed to investigate the epidemiology of CRBI, associated factors, mortality rate, and factors associated with mortality in patients with this infection. Methods: This cross-sectional descriptive-analytical study was conducted on 592 patients with catheter infections in the hemodialysis (HD) unit of Velayat Hospital in Qazvin province from 2018 to 2022. Patients’ demographic and clinical information was extracted from their medical records. Data analysis was performed using univariate and multivariate regression analyses. Results: Of the 592 patients, 261 (44%) were male and 331 (56%) were female. The majority of patients were in the 60 - 79 age group (277 individuals; 47.6%). The most common catheter insertion site was the cervical vein (270 individuals; 46.9%). Staphylococcus and Escherichia coli were the most prevalent catheter-related microorganisms, with 239 (41.4%) and 65 (11.2%) cases, respectively. The mortality rate among patients with catheter infections was approximately 20%. Femoral catheter placement compared to jugular placement and blood culture samples compared to Sheldon samples increased the odds of mortality by approximately 2.83 times. Conclusions: The study indicates that clinical factors such as catheter insertion site and duration of hospital stay are associated with mortality in HD patients. Therefore, implementing hygienic measures and focusing on these factors are crucial.