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- Title
Prevalence, Microbial Etiology and Risk Factors Associated With Healthcare Associated Infections Among End Stage Renal Disease Patients on Renal Replacement Therapy.
- Authors
Abbasi, Saad Hanif; Aftab, Raja Ahsan; Mei Lai, Pauline Siew; Lim, Soo Kun; Nur Zainol Abidin, Ruwaida
- Abstract
End stage renal disease (ESRD) patients on renal replacement therapy (RRT) have an increased risk of morbidity and mortality due to healthcare associated infections (HCAIs). The aim of this study is to determine the prevalence, microbial etiology, and risk factors associated with HCAIs among ESRD patients on RRT. A multicenter, retrospective study was conducted from June to December 2019. ESRD patients with minimum of 6 months on RRT were included, while pregnant patients and patients <18 years were excluded. To reduce the risk of selection bias, all patients were randomly selected using a simple random sampling technique. The prevalence showing the proportion of patients that acquired HCAI since the initiation of dialysis until 2019 was calculated using the European patients' academy (EUPATI) formula. Risk factors were assessed using univariate and multivariate regression analysis. The prevalence of HCAI among ESRD patients was 174/400 (43.5%). Catheter related bloodstream infection (CRBSI) was the most common infection [64(36.8%)], followed by peritonitis [45(25.8%)] and pneumonia [37(21.2%)]. Out of 382 total pathogens identified, 204 (53.4%) were Gram positive and 162 (42.4%) were Gram negative. Both methicillin sensitive staphylococcus aureus (MSSA) and methicillin resistant staphylococcus aureus (MRSA) showed statistically significant associations (p<0.05) with CRBSI. Use of multiple accesses, increased blood sugar levels, low serum sodium levels and higher CRP concentration increased the occurrence of HCAIs. The burden of HCAIs among the patients undergoing RRT is high. Preventive strategies and optimum empirical therapy of antibiotics should be used to reduce the risk of these infections among ESRD patients.
- Subjects
MALAYSIA; TREATMENT of chronic kidney failure; THERAPEUTICS; RESEARCH; PNEUMONIA; C-reactive protein; CATHETER-related infections; PERITONITIS; MULTIPLE regression analysis; SODIUM; RENAL replacement therapy; CROSS infection; RETROSPECTIVE studies; ACQUISITION of data; BLOOD sugar; RISK assessment; MEDICAL records; STATISTICAL sampling; HEMODIALYSIS; BLOODBORNE infections
- Publication
Journal of Pharmacy Practice, 2023, Vol 36, Issue 5, p1142
- ISSN
0897-1900
- Publication type
Article
- DOI
10.1177/08971900221094269