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Topic: kidney and urologic diseases (ku)
Title: Infections in Dialysis Patients.
Author: Arduino, M.J.; Lucero, C.; Patel, P.
Source: Nephrology News & Issues. 22(2):48-59. February 2008.
Abstract: This article reviews the problem of infections in dialysis patients, focusing on the causes of these infections and strategies to counter their negative effects. The authors remind readers that maintenance dialysis patients are at increased risk for infection due to well-defined immune deficits that are caused by the uremic state. These immune deficits in turn lead to increased rates of bacterial infections, particularly bloodstream infections and pneumonia. The authors discuss bloodborne pathogens of particular concern to patients on hemodialysis, notably hepatitis B, hepatitis C, and hepatitis D; HIV and AIDS; bacterial and fungal infections, particularly methicillin-resistant Staphylococcus aureus (MRSA); vascular access-related infections; and infections associated with water, dialysate, reuse, and dialysis machines. For each, the authors review transmission, host susceptibility, prevention, and infection control strategies. The article concludes with a list of 12 specific strategies that all dialysis facilities should consider implementing: vaccinate staff and patients; use catheters only when necessary, prefer fistulas or grafts; optimize access care; target the pathogen; access the experts; use local data; be wary of vancomycin use; treat infection, not contamination or colonization; stop antimicrobial therapy as soon as possible; follow infection control precautions; practice hand hygiene; and incorporate patients into access care and infection control measures. 21 references.

Format: Journal Article
Language: English.
Major Keywords: Kidney Diseases. Dialysis. Infection. Complications. Prevention. Infection Control. Bacterial Infections. Viral Infections. Fungal Infections.
Minor Keywords: Vascular Access. Fistula. Hemodialysis. Catheterization. Universal Precautions. Antibiotics. Antibiotic Resistance. Hepatitis B. Human Viral Hepatitis. Transmission. Risk Factors.
Publication Number: KUJA11815
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