HAEMODIALYSIS CATHETER RELATED BLOOD STREAM INFECTIONS IN FIJI.

Introduction Hemodialysis is a medical procedure used to remove excess fluid, waste products and to correct electrolyte imbalance in patients with acute or chronic renal failure. This procedure involves access to blood stream with the three most common types of access being; Internal arteria – venous fistula (AV fistula), Internal aterio – venous graft (AV graft) and Central venous catheter (CVC) or hemodialysis catheter (Napalkov et al, 2013). Currently CVC is the most common vascular access in end stage kidney disease patients maintained on hemodialysis in Fiji. There is no Data on Catheter Related Blood Stream Infections (CRBSI) in patients undergoing dialysis with catheters in Fiji.
Method: An analytical retrospective cross sectional study was carried oout on patients over the age of 18 undergoing hemodialysis in 2017 at all dialysis centres in Fiji.
Results: Out of the 150 patients on dialysis in 2017, 38 were excluded because 35 had an AV fistulas, 1 was less then 18years of age, 2 due to poor documentation. Eventually 112 patients were included of which 74 were in Central, 9 in the North and 29 in the western division. There were 10 probable CRBSI with 3 blood culture positive CRBSI nation wide. CRBSI was 0.1 per 1000 catheter days for culture positive in Fiji for 2017. The most common causative organism isolated was Streptococcus species.
Conclusion: CRBSI rates in patients undergoing hemodialysis is relatively low in Fiji.
Discussion: This study is the pioneer one for CRBSI in Fijis growing dialysis care. The major limitation was the poor standardized documentation on CRBSI in the patients with catheter for hemodialysis. This study sets a benchmark for future prospective studies whereby CRBSI suspicion clinical criterion, screening and Antibiotic choice could be standardized variable in the sample size.