%0 Journal Article
%T Antibiogram for Haemodialysis Catheter-Related Bloodstream Infections
%A Abdul Halim Abdul Gafor
%A Pau Cheong Ping
%A Anis Farahanum Zainal Abidin
%A Muhammad Zulhilmie Saruddin
%A Ng Kah Yan
%A Siti QaniaĦŻah Adam
%A Ramliza Ramli
%A Anita Sulong
%A Petrick Periyasamy
%J International Journal of Nephrology
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/629459
%X Background. Haemodialysis (HD) catheter-related bloodstream infections (CRBSIs) are a major complication of long-term catheter use in HD. This study identified the epidemiology of HD CRBSIs and to aid in the choice of empiric antibiotics therapy given to patients with HD CRBSIs. Methods. Patients with HD CRBSIs were identified. Their blood cultures were performed according to standard sterile technique. Specimens were sent to the microbiology lab for culture and sensitivity testing. Results were tabulated in antibiograms. Results. 18 patients with a median age of 61.0 years (IQR: 51.5¨C73.25) were confirmed to have HD CRBSIs based on our study criteria. Eight (44.4%) patients had gram-negative infections, 7 (38.9%) patients gram-positive infections, and 3 (16.7%) patients had polymicrobial infections. We noted that most of the gram-negative bacteria were sensitive to ceftazidime. Unfortunately, cloxacillin resistance was high among gram-positive organisms. Coagulase-negative Staphylococcus and Bacillus sp. were the most common gram-positive organisms and they were sensitive to vancomycin. Conclusion. Our study revealed the increased incidence of gram-negative organism in HD CRBSIs. Antibiogram is an important tool in deciding empirical antibiotics for HD CRBSIs. Tailoring your antibiotics accordingly to the antibiogram can increase the chance of successful treatment and prevent the emergence of bacterial resistance. 1. Introduction Chronic kidney disease (CKD) is a major public health burden [1]. The contribution of CKD to the global burden of disease may be underestimated due to the lack of significant importance in certain kidney disease classifications and failure to realize the relationship of CKD with cardiovascular disease [1]. The prevalence of end-stage renal disease (ESRD) is increasing exponentially worldwide. USA, Japan, and Taiwan had the highest rate of prevalence of ESRD [2]. In Malaysia, dialysis is the main modality of renal replacement therapy. There were about 26,000 patients on dialysis in 2011 with the prevalence of 900 per million populations [3]. Haemodialysis (HD) accounts for about 89% of dialysis patients and most of them were accepted to centre HD [4]. Unfortunately, not all patients enter HD program with a native vascular access. Many patients still presented late and HD access catheter, either cuffed or noncuffed catheters, is needed to perform HD. The use of HD catheter had increased from 3% in 2002 to 8.1% in 2011 of all vascular accesses [5]. We cannot argue that HD catheter plays a very important role in the treatment of
%U http://www.hindawi.com/journals/ijn/2014/629459/