Incidence and influencing factors associated with exit site infections in temporary catheters for hemodialysis and apheresis

Abstract

The authors examined the incidence and influencing actors of exit site infections (ESIs) in patients using dual and triple lumen dialysis catheters. The prospective, randomized study was conducted at 11 centers. Data were analyzed on 473 patients randomized to receive 235 dual lumen catheters (DLCs) or 238 triple lumen catheters (TLCs).

Results: ESIs occurred in 10 patients (2.1%). The number of intertreat-ment uses (p = 0.006), total number of uses (p = 0.009), and catheter placement duration (p = 0.03) were significantly associated with incidence of ESI in both treatment groups. Although patients with TLCs had a significantly higher inter-treatment use than patients with DLCs (p = .04), no sgnificant difference in the incidence of ESI was found (p = 0.11). Diabetic status and catheter insertion site were not found to be significantly related to ESI ( p= 0.09 and p = 0.54, respectively), although a trend toward significance was noted for diabetic status.

Conclusions: Stringent exit site care by specially trained staff and shorter catheter duration most likely contributed to the low incidence of ESIs. Other influencing factors included numbers of inter-treatment uses, total number of uses, and catheter placement duration.