SP575
FOLLOW UP OF HEMODIALYSIS PATIENTS WITH CATHETER RELATED BACTEREMIA CAUSED BY STAPHYLOCOCCUS AUREUS METICILIN RESISTANT (MRSA)

INTRODUCTION: The incidence of invasive MRSA infection among patients(pts) undergoing chronic dialysis is >100 times higher than in the general population. Increased risk of MRSA infections in dialysis patients is related to repeated vascular access for hemodialysis patients through central venous catheters (CVCs).

METHODS: We collected epidemiological and laboratory data on all cases of MRSA bacteremia at pts on hemodialysis with CVC , from December 31, 2010 to December 31, 2017. Demographic data, medical comorbidities (diabetes),duration of CVC, duration of hospitalization and antibiotic therapy, function and complications were recorded

RESULTS: We identified 52 episodes of MRSA bacteremia from 46 patients (24 males, 22 females, aged 57 years).Thirthy nine pts had temporary CVC, and 7 permanent CVC. More than a half of the patients have diabetes, and one third of the pts were on Chronic Hemodialysis Program more than 3 years. There were no differences in age, gender or severity of bacteraemia and comorbidities In logistic regression analysis, variables were duration time of CVC, type of previous venous access, previous use of antimicrobials, and previous hospitalization related to CRB. Previous hospitalization increased the chance of developing CRB, 6.6-fold (CI 95%: 1.9–23.09) All CVC were removed and new ones were inserted. Only one patient died, and two had complications- Spondylodiscites, all others were successfully cured. Vancomycin was most frequently administered antibiotic

CONCLUSIONS: : All MRSA catheter-related bacteraemia were successfully resolved by changing CVC and appropriate antibiotic therapy. Therefore, prevention activities should focus on improving CVC maintenance.Infection prevention measures for bloodstream infections related to central venous catheter use should be intensified. Adherence to current infection prevention guidelines should be encouraged and reinforced to help sustain the decreasing trend of invasive MRSA infections.