Antibiotic sensitivity pattern in hemodialysis catheter (tunneled/non-tunneled)-related bloodstream infections at a tertiary care center in North India

Abstract Background: Catheter-related bloodstream infections (CRBSIs) are a frequent and serious complication in hemodialysis patients requiring central venous catheters. Objectives: This study compared tunneled and non-tunneled catheters to evaluate bacterial isolate antibiotic susceptibility and resistance profiles from hemodialysis catheters. Materials and Methods: In total, 150 eligible Departments of Medicine and Nephrology patients, including their respective wards, were enrolled after obtaining written informed consent. Clinical data were collected, including fever, chills, purulent discharge, catheter tenderness, catheter type, insertion site and date, and catheter duration. Patients were followed daily until catheter removal, which occurred at a median duration of 27 to 180 days for tunneled catheters and 5 to 50 days for non-tunneled catheters. Upon removal, catheter tips were collected in sterile containers and sent for semi-quantitative culture in the microbiology laboratory. Concurrent blood and catheter tip cultures were analyzed for microbial growth and antibiotic sensitivity. Results: CRBSIs were observed in patients with a median age of 44 (IQR: 32.0–55.0). Gram-negative organisms were responsible for 52% of infections, with Pseudomonas aeruginosa comprising 40% of these isolates. Most Gram-negative bacteria were susceptible to imipenem and meropenem, with one exception among Pseudomonas isolates. Gram-positive bacteria accounted for 48% of infections, predominantly Staphylococcus aureus (55%), which showed consistent sensitivity to linezolid, vancomycin, and daptomycin. Conclusion: The study underscores the predominance of Gram-negative pathogens in CRBSIs among hemodialysis patients. Routine antibiogram data are essential for guiding appropriate empirical antibiotic therapy in managing these infections.