Incidence of catheter-association bloodstream infection among hemodialysis patients at Erbil Teaching Hospital

Rooted tree for bacterial species in hemodialysis patients

Abstract

The study objectives were to analyze catheter-associated bloodstream infection (CABSI) risk factors in chronic kidney disease on regular hemodialysis and identify the bacterial species responsible for this by molecular analysis. This research was conducted in Erbil Teaching Hospital-Dialysis Unit in Erbil City-Kurdistan Region-Iraq from January to June 2024. It has been performed on 100 hemodialysis samples from both males and females. The investigation showed that the prevalence of CABSI among hemodialysis patients was 44 (44%) out of 100 (100%). The highest percentage of patients were aged between 60-69 years (32%, OR= 0.9, 95%CI [0.1-2.4], P< 0.001) and also male (66%, OR=2.7, 95%CI [0.9-9.4], P< 0.032). Additionally, the patients with Diabetes Mellitus were 70%, (OR= 6.3, 95%CI [0.3-10.4], P< 0.031), and with hypertension was 92%, (OR= 3.1, 95%CI [0.21-5.4], P<0.02.  However, the dialysis duration of most patients was between 1-3 months (60%, OR=0.1, 95%CI [0.1-3.2], P<0.006) and the majority used two catheters (52%, OR= 0.6, 95%CI [0.1-3.2], P<0.012). The most common pathogens identified were Staphylococcus epidermis (44 cases, 100%), Pseudomonas aeruginosa (29 cases, 66%), and, Acinetobacter baumanni (24 cases, 55%). Thirteen bacterial species were recorded in the NCBI GenBank database. The phylogenetic tree demonstrated the distribution and relationship between these bacteria in hemodialysis patients. It showed that the bacterial species were closely related. To lower the risk of catheter-associated bloodstream infection, medical staff should actively develop countermeasures and gain a thorough understanding of the risk factors, which include age, diabetes, length of catheterization, and catheterization site.