Clinical And Microbiological Aspects Of Catheter Related Blood Stream Infection In Dialysis Population And Their Short-Term Outcome

Objective: To investigate the clinical and microbiological aspects of CRBSIs in the dialysis population of Pakistan and evaluate their short-term outcomes. Study Design: Quantitative, cross-sectional study Place and Duration of Study:Five different dialysis centers /clinics located in four different regions of Pakistan from December 2023-May 2024. Methodology: A multistage cluster sampling technique was employed to select a representative sample of dialysis centers from various provinces in Pakistan. Within each selected dialysis center, a systematic random sampling method was used to recruit participants who met the inclusion criteria.A self-administered, structured questionnaire was developed to collect data on participants’ demographic characteristics, comorbidities, catheter-related factors. Results: Out of 350 participants included in the trial , 89 patients (25.4%) had experienced at least one episode of CRBSI in the previous six months. Blood cultures were positive in 82.0% of cases, with Gram-positive bacteria being the most commonly isolated pathogens (67.4%). Staphylococcus aureus was the most frequently identified pathogen (28.1%). The mean duration of hospitalization for patients with CRBSI was 14.2 days (SD 5.6). The overall mortality rate among patients with CRBSI was 16.9%. Several factors were found to be significantly associated with the incidence of CRBSI, including a history of previous CRBSI (p < 0.001), catheter-related factors such as duration of catheter use (p = 0.002) and lack of catheter care education (p = 0.017), and comorbidities such as diabetes mellitus (p = 0.002) and cardiovascular disease (p = 0.039). Conclusion: Especially in poor and medium income countries like Pakistan, our results highlight the need of ongoing efforts to prevent and control CRBSIs in the dialysis population. Keywords : Catheter related blood stream infection, dialysis,short term outcome.