Kidney dialysis-related infection rates higher in U.S. minorities
-report
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[February 07, 2023]
By Nancy Lapid
(Reuters) - Preventable bloodstream infections related to kidney failure
treatment are more common in U.S. Blacks and Hispanics than in whites,
according to a report from the Centers for Disease Control and
Prevention (CDC) released on Monday.
Use of neck veins for administration of hemodialysis was the most
important risk factor, but not the only one, researchers said in the
CDC's Morbidity and Mortality Weekly Report.
Using data from multiple national databases collected between 2017 and
2020, they estimated that potentially deadly Staphylococcus (or S.)
aureus bloodstream infections occurred in 4,751 of every 100,000 Black
patients receiving hemodialysis and 4,500 of every 100,000 Hispanic
patients compared with 3,866 of every 100,000 white late-stage kidney
disease patients receiving these treatments.
Roughly 40% of the infections were resistant to treatment with the
antibiotic methicillin, the report found.
Patients whose kidney function falls below a certain level require a
dialysis machine periodically to do the organs' work of cleansing the
blood.
The most significant risk factor for the serious and potentially deadly
infection was administration of dialysis though a large "central vein"
catheter in the neck.
Use of a central venous catheter for hemodialysis conferred a
six-times-higher risk for S. aureus bloodstream infection compared to
use of a port in the arm known as a fistula, the researchers found.
![](http://archives.lincolndailynews.com/2023/Feb/07/images/ads/current/firststatemortgage_sda_020223.png)
The highest use of central venous catheters was seen in Black patients
ages 18 to 49.
Ideally, as kidney function deteriorates and patients get closer to
needing dialysis, doctors recommend a surgical procedure to create the
fistula, with an artery connected to a vein.
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![](../images/020723PIX/health55.jpg)
A general view of the Centers for
Disease Control and Prevention (CDC) headquarters in Atlanta,
Georgia September 30, 2014. REUTERS/Tami Chappell
![](http://archives.lincolndailynews.com/2019/Sep/05/images/ads/current/stclara_lda_SPONSOR_090519.png) Without the fistula, dialysis must
be administered via a catheter in a large central vein in the neck,
which is associated with higher rates of complications, including
infections, and should only be used temporarily.
Even after accounting for use of these catheters, the risk of S.
aureus bloodstream infections was still higher in Hispanics than in
whites.
"Central venous catheter use was the most important risk factor but
didn't entirely explain the higher risk in Hispanic patients," said
study leader Dr. Shannon Novosad, team lead for Dialysis Safety in
CDC's Division of Healthcare Quality Promotion.
There were also more S. aureus bloodstream infections in areas with
higher poverty, crowding, and lower education levels.
"Overall these are complex relationships that deserve additional
study," Novosad said.
Her team called for research to help minimize central venous
catheters use, address possible barriers to use of safer routes for
hemodialysis access, and improve education of patients and
healthcare providers.
"We need to focus interventions that we know work to prevent
infections, specifically in these (high-risk) groups," Novosad said.
(Reporting by Nancy Lapid; Editing by Bill Berkrot)
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