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Practice Guideline
. 2019 Sep;24(9):951-957.
doi: 10.1111/nep.13511. Epub 2019 Apr 29.

Kidney Health Australia - Caring for Australasians with Renal Impairment guideline recommendations for infection control for haemodialysis units

Meg Jardine  1   2 , Robert J Commons  3 , Janak R de Zoysa  4   5 , Muh G Wong  1   6   7 , Nicole Gilroy  7   8 , Julianne Green  8 , Belinda Henderson  9 , Rhonda L Stuart  10   11 , David J Tunnicliffe  12   13 , Carolyn van Eps  14 , Eugene Athan  15
Affiliations
Practice Guideline

Kidney Health Australia - Caring for Australasians with Renal Impairment guideline recommendations for infection control for haemodialysis units

Meg Jardine et al. Nephrology (Carlton). 2019 Sep.

Abstract

Aim: There is no national consensus on infection control in haemodialysis units in Australia and New Zealand. The primary aim of this guideline was to provide recommendations on screening for blood-borne viruses and multi-resistant organisms for dialysis units based on the available evidence.

Methods: The Kidney Health Australia Caring for Australasians with Renal Impairment guidelines, overall approach to guideline development follows the GRADE framework. A facilitated workshop was conducted to ensure that patient and caregiver concerns were considered. The evidence from relevant medical databases on the impact of screening on detection and transmission rates, hospitalization, mortality and psychosocial care, was reviewed and critically appraised. The guideline group made recommendations from the evidence available.

Results: The main guideline recommendations are: Dialysis units adopt a comprehensive approach that encompasses standard infection control precautions. Conduct routine surveillance for key blood-borne viruses and methicillin-resistant Staphylococcus aureus. Conduct routine surveillance of individual levels of protection against hepatitis B for patients on haemodialysis. Use dedicated dialysis machines for HBV-infected patients. The evidence in totality was not found to support routine surveillance of vancomycin-resistant Enterococci . Enhanced surveillance in light of the local risk of transmittable infectious agents should be considered by dialysis units. Very few studies have reported on the potential adverse effects of screening and associated practices.

Conclusions: Future research should focus on the potential benefits and adverse effects of screening and associated practices on clinical outcomes including infections prevented and health service delivery, and psychosocial domains for patients. Given the results of trials in the critical setting, the effectiveness of methicillin-resistant Staphylococcus aureus decolonization in people receiving dialysis therapy warrants further research.

Keywords: blood borne virus; haemodialysis; infectious disease; multidrug resistant organism; practice guideline.

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References

REFERENCES

    1. Harkins CP, Pichon B, Doumith M et al. Methicillin-resistant Staphylococcus aureus emerged long before the introduction of methicillin into clinical practice. Genome Biol. 2017; 18: 130.
    1. Huskins WC, Huckabee CM, O'Grady NP et al. Intervention to reduce transmission of resistant bacteria in intensive care. N. Engl. J. Med. 2011; 364: 1407-18.
    1. Jain R, Kralovic SM, Evans ME et al. Veterans affairs initiative to prevent methicillin-resistant Staphylococcus aureus infections. N. Engl. J. Med. 2011; 364: 1419-30.
    1. Huang SS, Septimus E, Kleinman K et al. Targeted versus universal decolonization to prevent ICU infection. N. Engl. J. Med. 2013; 368: 2255-65.
    1. Harris AD, Pineles L, Belton B et al. Universal glove and gown use and acquisition of antibiotic-resistant bacteria in the ICU: A randomized trial. JAMA 2013; 310: 1571-80.

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