| Theme | Controlling Infections in Dialysis Patients | |
|---|---|---|
| Title | Vascular access infection | |
| Publish Date | 2009/01 | |
| Author | Kazuaki Soejima | Kidney and Urology Center, Saiseikai Kumamoto Hospital |
| [ Summary ] | Vascular access (VA) infection is a serious complication for hemodialysis patients. Primary arteriovenous fistula (AVF) infection presents the lowest infection risk. Most of VA infections are graft infections or catheter infections. Graft infections are caused by failures in canunlation or improper AV management. Antibiotic administration and the removal of infected grafts are indispensable in treating graft infections. Catheter infections usually occur in the exit region. Certain treatments for temporary catheter infections employ removal of catheters in the infected region. On the other hand, with permanent catheters, salvage treatments will be attempted, for instance antibiotic therapy, disinfection of the exit region and creation of a new tunnel. If infection extends inside the permanent catheter region, it is necessary to remove it immediately. VA pathogen infections are generally from the skin flora. In data from our institution, 90 % of pathogens associated with VA septicemia infection were Staphylococcus aureus while 40 % were associated with MRSA. For this reason, vancomycin should be selected for the treatment of VA infection with septicemia. VA infection is a serious complication that maintains VA that is life line for hemodialysis patient difficult, makes to septicemia easily, and threatens patient's life. Hemodialysis staff members should make every effort to detect eariy stage VA infection. If VA infection occurs, it is necessary to provide appropriate treatment as promptly as possible. |
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