Most Dialysis Bloodstream Infections Linked To Central Line Catheters: Study

Federal health experts are warning that catheters appear to be a frequent cause of bloodstream infections among dialysis patients, which can cause further health complications and be life threatening. 

In a dialysis surveillance report published late last month in the Clinical Journal of the American Society of Nephrology, researchers from the U.S. Centers for Disease Control and Prevention (CDC) indicate that nearly two-thirds of all bloodstream infections reported among dialysis patients occurred among those with a central line catheter.

Central line blood infections are a healthcare-associated problem, which affects patients hospitalized and treated for a variety of different conditions, including dialysis patients.

A central line is an intravenous catheter inserted directly into a major vein, near the heart, to transfuse blood or insert medications. Central line infections are contracted in a hospital within 48 hours after the central line has been inserted.

It is estimated that central line catheter infections cost the health care system about $45,000 per case, and hospitals have made substantial efforts in recent years to implement new safety procedures to reduce the risk. These safety measures include using sterile gloves, covering catheters with antimicrobial dressings and checking catheters daily for signs of infection or movement. Yet, not all hospitals have implemented these measures and it is unclear how well they have been implemented at dialysis centers.

The CDC’s report used dialysis event surveillance data from 2014 that was collected by the National Healthcare Safety Network (NHSN). It included information from 6,005 outpatient hemodialysis facilities. The facilities reported 160,971 dialysis events for 2014, including 29,516 bloodstream infections.

According to the findings, 63% of dialysis bloodstream infections occurred among those with a central line catheter, with 70% of access-related infections coming from central line catheter patients. The CDC determined that the rate of bloodstream infections was 2.16 per 100 patient-months for central line catheter patients.

“The 2014 National Healthcare Safety Network Dialysis Event data represent nearly all United States outpatient dialysis facilities,” the study’s authors note. “Rates of infection and other dialysis events were highest among patients with a central venous catheter compared with other vascular access types.”

According to the findings of a study published earlier this year, the use of catheter safety measures in hospitals decreased the number of central line bloodstream infections by 57%. Hospitals also saved an average of $1.85 million over three years.

A study published in 2014 indicated hospitals were able to reduce central line infections by 68 percent over two years using disinfection caps. Another study found that by replacing connectors with zero fluid displacement connectors on central lines bloodstream infections dropped 60% to 94%.

The use of central line catheters are linked to more than 60,000 primary bloodstream infections every year, according to researchers. About 12% of such infections result in the death of the patient.