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Prevention of catheter-related bloodstream infections in patients on hemodialysis: challenges and management strategies

Authors Soi V, Moore C, Kumbar L, Yee J

Received 1 October 2015

Accepted for publication 25 December 2015

Published 18 April 2016 Volume 2016:9 Pages 95—103


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Damodara Gullipalli

Peer reviewer comments 3

Editor who approved publication: Professor Pravin Singhal

Video abstract presented by Vivek Soi

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Vivek Soi, Carol L Moore, Lalathakasha Kumbar, Jerry Yee

Division of Nephrology and Hypertension, Henry Ford Health System, Detroit, MI, USA

Catheter-related bloodstream infections are a significant source of morbidity and mortality in the end-stage renal disease population. Although alternative accesses to undergoing renal replacement therapy exist, many patients begin hemodialysis with a dialysis catheter due to logistic and physiologic factors involved in arteriovenous fistula creation and maturation. Colonization of catheters via skin flora leads to the production of biofilm, which acts as a reservoir for virulent bacteria. Preventative therapies center on appropriate catheter maintenance, infection control measures, and early removal of devices as patients transition to other access. Despite best efforts, when conservative measures fail to prevent infections in a high-risk population, antimicrobial lock therapy should be considered as an option to combat catheter-related bloodstream infections.

Keywords: hemodialysis, CRBSI, catheter, end-stage renal disease, ESRD

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