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Evaluation of catheter infection rates in converted dialysis catheters versus de novo placement in the setting of chlorhexidine use. J Vasc Access 2016 Mar-Apr;17(2):162-6

Date

12/15/2015

Pubmed ID

26660045

DOI

10.5301/jva.5000490

Scopus ID

2-s2.0-84960435286   3 Citations

Abstract

PURPOSE: Prior studies have reported infection rates of converting non-tunneled dialysis catheters (NTDCs) to tunneled dialysis catheters (TDCs) versus de novo placement of TDCs using povidone-iodine. Chlorhexidine, per the Center of Disease Control guidelines, has been exclusively used in our institution since 2005. Therefore, our study aims to determine whether there is a difference in infection rates between conversion and de novo placement when utilizing chlorhexidine.

MATERIALS AND METHODS: A retrospective analysis from 1/1/2009 to 8/10/2012 was performed of patients who underwent placement of NTDCs, which were subsequently converted to TDCs and those who underwent de novo TDC placement. To assess the rate of infection, the following data points were collected: date of procedure(s), indication, outcomes, site of catheter insertion, pre- and post-procedure laboratory values, complications, infection rates within the life of the initially placed catheter, catheter days, and survival.

RESULTS: The conversion cohort was composed of 205 patients, 135 of whom were lost to follow-up, leaving 70 patients. The de novo cohort included 70 randomly selected patients. Of the 70 patients who underwent conversion, 23 developed a catheter-related infection, with an infection rate of 0.26 events per 100 catheter days. Of the 70 de novo catheters, 20 developed infection with an infection rate of 0.25 events per 100 catheters days.

CONCLUSION: In this series, there is no difference in infection rates between conversion and de novo TDC placement when utilizing chlorhexidine as the sterilization agent. However, these infection rates are superior to those reported when using povidone-iodine.

Author List

Criddle JM, Hieb RA, White SB, Patel PJ, Hohenwalter EJ, Tutton SM, Rilling WS

Authors

Robert A. Hieb MD Professor in the Radiology department at Medical College of Wisconsin
Eric J. Hohenwalter MD Chief, Professor in the Radiology department at Medical College of Wisconsin
Parag J. Patel MD, MS, FSIR Professor in the Radiology department at Medical College of Wisconsin
William S. Rilling MD Vice Chair, Professor in the Radiology department at Medical College of Wisconsin
Sean Tutton MD Vice Chair, Professor in the Radiology department at Medical College of Wisconsin
Sarah B. White MD, MS, FSIR Vice Chair, Associate Professor in the Radiology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Catheter-Related Infections
Catheterization, Central Venous
Catheters, Indwelling
Central Venous Catheters
Chlorhexidine
Disinfectants
Equipment Design
Humans
Kaplan-Meier Estimate
Kidney Failure, Chronic
Middle Aged
Renal Dialysis
Retrospective Studies
Time Factors
Treatment Outcome
Young Adult
jenkins-FCD Prod-480 9a4deaf152b0b06dd18151814fff2e18f6c05280