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Nephrol Dial Transplant (2000) 15: 1281-1284
© 2000 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

Changing patterns of antibiotic resistance—update on antibiotic management of the infected vascular access

Renaat A. Peleman1,, Dirk Vogelaers1 and Gerda Verschraegen2

1 Department of Internal Medicine, Division of Infectious Diseases and 2 Department of Microbiology, University Hospital, Ghent, Belgium

Introduction

Haemodialysis can be performed either through permanent arteriovenous (a-v) access, such as a fistula or a graft, or through temporary catheter access. Infection associated with haemodialysis catheters has emerged as one of the most prominent and most serious complications encountered in dialysis patients, and remains a significant cause of morbidity and mortality. This editorial is aimed at providing an update on changing management attitudes towards the infected vascular access as well as on changing patterns of antibiotic resistance, due to shifts of causative micro-organisms and antimicrobial susceptibilities.

Types of vascular access

Haemodialysis requires a reliable, repetitive access to the circulation, capable of providing rapid extracorporeal blood flow. Permanent vascular access should be easily accessible and suitable for undisturbed, long-term use. This is generally obtained by an a-v fistula, by a synthetic a-v fistula (a-v graft) composed of polytetrafluoroethylene (PTFE), or by a catheter, either for acute or for chronic use (double-lumen, cuffed tunnelled catheters) . . . [Full Text of this Article]

Epidemiology of vascular access infection

Risk factors for septicaemia

Emerging resistance

Management of the infected vascular access (diagnosis, management) Diagnosis

Management

Antibiotic therapy

Catheter management

Salvage of the catheter
Catheter exchange
Catheter removal
Prevention of catheter infection

Practical guidelines

Notes

References


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Home page
 Nephrol Dial TransplantHome page
J. Lemus, H. Parra, and A. Undurraga
Antibiotic management of infected vascular access
Nephrol. Dial. Transplant., July 1, 2001; 16(7): 1521 - 1521.
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