Interventions for Preventing Infectious Complications in Haemodialysis Patients with Central Venous Catheters

Abstract

Vascular access is the main risk factor for bacteraemia, hospitalisation, and mortality among haemodialysis (HD) patients. The type of vascular access most associated with bloodstream infection is central venous catheter (CVC). The incidence of catheter-related bacteraemia ranges between 0.50 and 6.18 episodes per 1,000 catheter days and increases linearly with the duration of catheter use. Given the high prevalence of CVC use and its direct association with catheter-related bacteraemia, which adversely impacts morbidity and mortality rates and costs among HD patients, several prevention measures aimed at reducing the rates of CVC-related infections have been proposed and implemented. As a result, many clinical trials, systematic reviews, and meta-analyses have been conducted to assess the effectiveness, clinical applicability, and long-term adverse effects of such measures. An integrative review was conducted on prophylactic measures against CVC-related infections in HD patients, identifying their potential advantages and limitations. A literature search was performed within multiple databases and meta-analyses on clinical experience with prophylactic antimicrobial therapy in HD CVC were reviewed and appraised.