Hemodialysis-associated bloodstream infections (BSIs) pose a significant health hazard and could be fatal for patients undergoing maintenance hemodialysis. It is essential to understand the trends of BSIs among such patients to reduce their incidence and improve patient health outcomes, thereby mitigating an infection-related death rate that is about 20 times higher than that of the general population. A recent study aimed to analyze the trends, identify the causative pathogens, assess resistance patterns, and determine the sources of hemodialysis-associated BSIs over a period of nearly two decades at Geneva University Hospitals. The Hemodialysis unit at the hospital, capable of treating around 60 patients, has been implementing Staphylococcus aureus screening and decolonization of hemodialysis patients since 2000.
The study involved a longitudinal cohort and utilized data from 2006 to 2023, providing insightful revelations. It recorded a total of 313 authentic BSI episodes among 218 hemodialysis patients over around 11,413 patient-hemodialysis months. Overall, the BSI incidence rate was at 2.7 episodes per 100 patient-Hemodialysis months, with a consistent decrease over time. Between 2006-08 and 2021-23, hemodialysis-associated BSI rates dropped by a massive 44%. This decline was largely driven by reduced S. aureus BSIs, while Enterobacterales BSIs rates remained mostly stable.
Moreover, catheter-related BSIs were found to be the source of around 41.5% of infections, with a pronounced reduction noted after 2014. BSIs induced by antibiotic-resistant bacteria were surprisingly low, with decreasing trends of methicillin-resistant S. aureus. Essentially, the findings of the study highlight the significance of preventing hemodialysis-associated BSIs for reducing the infection burden among hemodialysis patients.
Collecting data on healthcare-related BSI and assessing secular trends, causative pathogens, and antimicrobial resistance patterns is vital. This study underscores the critical importance of implementing effective infection control measures, such as S. aureus targeted screening, and proper catheter care to reduce BSIs in vulnerable patient populations. Notably, successful infection control protocols have shown potential for significant BSI prevention in HD patients, including a reduction in overall BSI rates by 32% and a 54% decrease in access-related BSIs according to a previous study.
Source: https://aricjournal.biomedcentral.com/articles/10.1186/s13756-025-01620-8