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Preventing infections in dialysis patients

A recent report published by the Centers for Disease Control and Prevention outlines the challenges faced by 800,000 people in the United States who are living with end-stage kidney disease. The article, published in the CDC’s Morbidity and Mortality Weekly Report, is titled “Vital Signs: Health Disparities in Hemodialysis-Associated Staphylococcus aureus Bloodstream Infections – United States, 2017-2020.” Most of these patients receive regular dialysis treatments to filter and remove waste and excess fluids from their bloodstream.

The major challenge in adult patients receiving kidney dialysis is a 100-times greater likelihood of developing a staph related bloodstream infection than adults not on dialysis, as shown by pre-pandemic data from 2017 to 2020. In 2020, for example, more than 14,000 bloodstream infections occurred in patients receiving dialysis, with over one-third of these cases caused by staph. 

With the widespread adoption of proven practices to prevent and control infections, the number of bloodstream infections on dialysis patients has been trending down since 2014. However, more can be done to further reduce the number of dialysis-related bloodstream infections each year, including:

• Encouraging practices that are known to prevent or slow the progression of chronic kidney disease.
  • Better management of conditions like diabetes and high blood pressure, particularly in underserved communities. For example, African Americans make up only 12% of the total U.S. population but are 33% of patients receiving dialysis.
• Using lower infection risk vascular access types for dialysis, such as fistula access in the wrists, as opposed to the high infection risk central venous catheter access.
• Continuing and expanding the application of proven practices to prevent and control the incidence and spread of infections at all dialysis facilities in the United States.
  • Rapid diagnostic tests for bloodstream infections and Antimicrobial Resistance (AMR), such as the FilmArray BCID2 Panel.

A comprehensive test such as the FilmArray BCID2 Panel for sepsis needs a comprehensive control that verifies every step of the test procedure. MDx-Chex™ for BCID2 from Streck is the only such control on the market. MDx-Chex for BCID2 is comprised of intact, inactivated microorganisms in a matrix of stabilized RBCs, WBCs, platelets and blood culture media components. It contains all 43 targets (microorganisms and AMR genes) and can verify the entire analytical process of the assay.