| [ Summary ] |
Patients receiving regular dialysis treatment are likely to develop sepsis and most of the responsible etiological organisms are transmitted via vascular access, especially intravascular catheters. Staphylococcus aureus is the most common organism causing sepsis and methicillin-resistant Staphylococcus aureus (MRSA), candida albicans is also seen in immunocompromised patients, such as those with end-stage renal failure (ESRF). MRSA sepsis tends to occur in patients with intravascular catheters and associated nasal carriage. This condition is reported to be more frequently detected in dialysis patients than in healthy ones. In order to manage sepsis it is necessary to remove infectious foci such as intravascular catheters or abscesses, in addition to employing intravenous administration of antibiotics which can combat pathogens. When antibiotics are administered to patients with ESRF, dosages and intervals must be adjusted. Therapeutic drug monitoring (TDM) is very useful, especially for cases of MRSA sepsis. When sepsis cannot be managed, in spite of early exclusion of infectious foci, the prognosis will be very poor because of a strong tendency for these organisms to be resistant to antibiotic therapy. Standard precautions are the most important factors to prevent the expansion of infection because many organisms associated with sepsis are primarily transmitted via contact. |