Black and Hispanic Dialysis Patients Face Higher Risks of Bloodstream Infections Due to Poor Care: CDC

While all dialysis patients face an increased risk of contracting bloodstream infections, federal health researchers indicate that the the risk is disproportionately higher for Black and Latino individuals.

The U.S. Centers for Disease Control and Prevention (CDC) published a new study in the latest issue of its Vital Signs Morbidity and Mortality Weekly Report, indicating that Black and Latino patients suffer Staphylococcus aureus bloodstream infections linked to dialysis at rates 100 times higher than patients not on hemodialysis.

Researchers used data from the 2020 National Healthcare Safety Network and the 2017-2020 Emerging Infections Program to determine bloodstream infections among patients on hemodialysis.

The information was linked to population-based data sources including the CDC/Agency for Toxic Substances and Disease Registry Social Vulnerability Index, the United States Renal Data System, and the U.S. Census Bureau to examine links with race, ethnicity, and social determinants of health.

Dialysis Infection Risks

More than half a million Americans undergo dialysis treatments every year, which involves filtering toxins from the blood because the kidneys no longer function properly. Hemodialysis involves the use of needles and catheters to conduct the procedures, which exposes patients to a known risk of bloodstream infections.

The data from the study indicates patients on hemodialysis had rates of bloodstream infections 100 times higher than patients not on dialysis.

More than 4,800 dialysis facilities participating in the Emerging Infections Program reported 14,822 bloodstream infections. Of those, 34% were linked to S. aureus infections, a serious type of infection that can become resistant to antibiotics.

According to the findings, Black and Latino patients face a disproportionately higher risk of suffering from end-stage kidney disease and needing dialysis. Patients on dialysis face an increased risk of developing S. aureus bloodstream infections.

The type of dialysis a patient is given is a risk factor for bloodstream infections and central venous catheters have the highest risk compared to other methods. Patients who used a central venous catheter for dialysis faced a higher risk of infection because the tube was inserted directly into a vein in the neck or chest.

Roughly one in three of the bloodstream infections reported in the study were due to S. aureus.

Latino and Black patients faced a disproportionate risk of suffering from S. aureus bloodstream infections compared to white patients, the CDC found. Latinos faced a 40% increased risk of bloodstream infection, while Black patients faced a 10% increased risk.

After adjusting for other factors like sex, residential location, and vascular access type of dialysis, Latinos still faced an extremely high risk of bloodstream infections compared to other patients.

Many factors are linked to the increased risk including living in areas with higher poverty levels, crowding, and lower education levels. Black and Latino patients also face a higher risk because they suffer from higher rates of diabetes and hypertension compared to white patients.

Higher rates of risk linked to race and socioeconomic factors may also be due to implicit bias in the healthcare industry. Additionally, many patients who face economic disadvantages are more likely to be intimidated by the healthcare system and less likely to seek medical treatment.

Researchers emphasized the need for public health providers to focus on prevention and optimized treatment for kidney disease and administering dialysis. Doctors and researchers should identify barriers to lower the risk of vascular placement and investigate practices to prevent bloodstream infections, especially among disadvantaged groups.