Rapid diagnosis of catheter related sepsis in hemodialysis patients

Abstract

Purpose: To distinguish between infected and non-infected Central Venous Catheters (CVCs) applied to hemodialysis patients without having to wait bacterial cultures, we evaluated the importance of sera C-Reactive Protein (CRP) test results to diagnose Catheter Related Sepsis (CRS) and compared this test with microbiologic cultures. Patients and Methods: Fifty-eight hemodialysis patients (16 Acute Renal Failure and 42 Chronic Renal Failure) and 81 CVCs applied to these patients were followed up. Twenty-six (45%) were female, 32 (55%) male, and the mean age was 46 (SD: 15; range: 15-70) years. When CRS was clinically suspected, catheters were removed and catheter tips cultured using semiquantitative method, or simultaneously blood samples were taken from catheters and peripheral vein for blood cultures. At the same time, peripheral blood samples were taken and sera CRP levels were tested with semiquantitative latex method. Results: Forty suspected and microbiologically confirmed CRS episodes were detected in two year follow up period. The sera CRP test was 95% sensitive and 78% specific (accepted 12 mg/L and higher levels as a CRS) in the diagnosis of microbiologically defined CRS. Conclusion: Results are available in minutes, using CRP test there fore fewer CVCs may have to be removed on suspicion of CRS in hemodialysis patients.