dc.contributor.author | Ngigi, J | |
dc.date.accessioned | 2013-05-23T12:04:54Z | |
dc.date.available | 2013-05-23T12:04:54Z | |
dc.date.issued | 2005 | |
dc.identifier.citation | M.Med (Internal Medicine) Thesis | en |
dc.identifier.uri | http://erepository.uonbi.ac.ke:8080/xmlui/handle/11295/24867 | |
dc.description | Master of Medicine Thesis | en |
dc.description.abstract | Background
Vascular access is the "Achilles heel" of haemodialysis.
Different types of angioaccess are in use and of this, catheters constitute the majority. One of
the major drawbacks to the catheter accesses is various forms of catheter- related infections.
These infections constitute a significant contribution towards the morbidity and mortality so
often observed among haemodialysis patients.
Objective
To determine the prevalence of haemodialysis catheter related infections and associated risk
factors among patients undergoing maintenance haemodialysis at the renal unit of the Kenyatta
National hospital
Design
Cross-sectional descriptive study.
Setting
Renal unit of the Kenyatta National Hospital.
Study population
Patients on maintenance haemodialysis who had a temporary, uncuffed subclavian catheter or a
permanent, cuffed internal jugular vein catheter for haemodialysis were recruited. Baseline
data including temperature, blood pressure, pulse rate and respiratory rate were taken and
recorded. A physical examination was also carried out before blood for haemogram, serum
albumin and culture was drawn. Exit site swabs and tips of removed catheters were cultured
and any bacterial isolates were subjected to sensitivity tests against selected antibiotics.
Associated risk factors, age, sex, type of catheter (cuffed versus uncuffed), duration of catheter
stay,albumin and diabetes for the catheter related infections were assessed
sults:
Fifty seven patients with either a subclavian catheter or an internal jugular catheter were
recruited into the study. The mean age of the patients was 46.32 ± 2.0 yrs with 40 %( 23)
females and 60 %( 34) males. Forty nine percent of the patients had a subclavian catheter while
51 %( 29) had an internal jugular vein catheter.
The mean serum albumin within the study group was 44.286± 1.286 g/dl, mean haemoglobin
8.531±0.24g1dl and the mean temperature was 36.90c. The commonest reason for catheter
change within the preceding six months was due to catheter related infection. Thirty five
percent of the patients reported use of antibiotics due to catheter related infection within the
preceding one month. The commonest type of catheter related infection was exit site infection
with a prevalence of 58% followed by tunnel infection with 14% prevalence. Staphylococcus
aureus was the commonest organism cultured from both exit site and blood with high
sensitivity to many of the commonly used antibiotics. One patient had an MRSA. There was no
relationship between infection and level of albumin, age, catheter type or diabetes but females
weremore likely to get exit site infection than males.
Conclusion:
Exit site infection is the commonest type of catheter infection among patients undergoing
chronic haemodialysis using catheters in the renal unit of Kenyatta National Hospital.
Staphylococcus aureus is the commonest cause and is highly sensitive to commonly used
antibiotics. | en |
dc.description.sponsorship | University of Nairobi | en |
dc.language.iso | en | en |
dc.title | Haemodialysis catheter related infections among patients undergoing maintenance haemodialysis in the renal unit - Kenyatta National Hospital | en |
dc.type | Thesis | en |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |
local.publisher | Department of Medicine, University of Nairobi | en |