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Complications of Staphylococcus aureus Bacteremia: Occurrence in Patients Undergoing Long-term Hemodialysis

Complications of Staphylococcus aureus Bacteremia: Occurrence in Patients Undergoing Long-term... Abstract • Since Staphylococcus aureus bacteremia continues to be a common occurrence in patients with arteriovenous fistulas who are undergoing long-term hemodialysis, the complications and outcome of 37 episodes of bacteremia were examined. Systemic complications included pulmonary emboli, empyema, persistent bacteremia, and endocarditis. Such events were rarely life threatening—three of the 34 episodes involving patients without severe concurrent medical problems resulted in death. Local complications at the fistula site were common; however, thrombosis, hemorrhage, impending rupture, and persistent bacteremia caused loss of fistula in 13 of the 22 episodes seen with fistula inflammation. Results of this study demonstrate that, although loss of vascular access was an important problem, particularly in patients with prosthetic grafts, patients with S aureus bacteremia who were undergoing long-term hemodialysis had a favorable prognosis for survival, particularly when they were compared with other patients not undergoing hemodialysis. (Arch Intern Med 1982;142:1655-1658) References 1. Dobkin JF, Miller MH, Steigbigel NH: Septicemia in patients on chronic hemodialysis. Ann Intern Med 1978;88:28-33.Crossref 2. Linneman CC, McKee E, Laver MC: Staphylococcal infections in a hemodialysis unit. Am J Med Sci 1978;276:67-75.Crossref 3. Mennes PA, Gilula LA, Anderson CB, et al: Complications associated with arteriovenous fistulas in patients undergoing chronic hemodialysis. Arch Intern Med 1978;138:1117-1121.Crossref 4. Nsouli KA, Lazarus JM, Schoenbaum SC, et al: Bacteremic infection in hemodialysis. Arch Intern Med 1979;139:1255-1258.Crossref 5. Septicaemia in dialysis patients, editorial. Lancet 1980;1:521-522. 6. Bierman MH, Needham-Walker CA, Hammeke M, et al: Vancomycin therapy for serious staphylococcal infections in chronic hemodialysis patients. J Dial 1980;4:179-184. 7. Gombos EA, Jefferson DM, Bhat JG: Effect of hemodialysis on immune response. Proc Eur Dial Transplant Assoc 1975;11:367-374. 8. Greene WH, Casann RS, Mauer M, et al: The effect of hemodialysis on neutrophil chemotactic responsiveness. J Lab Clin Med 1976;88:971-974. 9. McIntosh J, Hansen P, Ziegler J, et al: Defective immune and phagocytic function in uremia and renal transplantation. Int Arch Allergy Appl Immunol 1976;51:544-550.Crossref 10. Cross AS, Steigbigel RT: Infective endocarditis and access site infections in patients on hemodialysis. Medicine 1976;55:453-466.Crossref 11. Nolan CM, Beaty HN: Staphylococcus aureus bacteremia. Am J Med 1976;60:495-502.Crossref 12. Iannini PB, Crossley K: Therapy of Staphylococcus aureus bacteremia associated with a removable focus of infection. Ann Intern Med 1976;84:558-563.Crossref 13. Watanakunakorn C, Baird IM: Staphylococcus aureus bacteremia and endocarditis associated with a removable infected intravenous device. Am J Med 1977;63:253-256.Crossref 14. Shah M, Watanakunakorn C: Changing patterns of Staphylococcus aureus bacteremia. Am J Med Sci 1979;278:115-121.Crossref 15. Smith I: Staphylococcus aureus , in Mandell GL, Douglas RG, Bennett JE (eds): Principles and Practice of Infectious Diseases . New York, John Wiley & Sons Inc, 1979, pp 1530-1552. 16. Banks T, Fletcher R, Ali N: Infective endocarditis in heroin addicts. Am J Med 1973;55:444-452.Crossref 17. Leonard A, Comty CM, Shapiro FL, et al: Osteomyelitis in hemodialysis patients. Ann Intern Med 1973;78:651-656.Crossref 18. Goodwin NJ, Castronuovo JJ, Friedman EA: Recurrent septic pulmonary embolization complicating maintenance hemodialysis. Ann Intern Med 1969;71:29-38.Crossref 19. Nicholls A, Edward N, Catto GRD: Staphylococcal septicemia, endocarditis, and osteomyelitis in dialysis and renal transplant patients. Postgrad Med J 1980;56:642-648.Crossref 20. Kirmani N, Tuazon CU, Murray HW, et al: Staphylococcus aureus carriage rate of patients receiving long-term hemodialysis. Arch Intern Med 1978;138:1657-1659.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Complications of Staphylococcus aureus Bacteremia: Occurrence in Patients Undergoing Long-term Hemodialysis

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1982.00340220071014
Publisher site
See Article on Publisher Site

Abstract

Abstract • Since Staphylococcus aureus bacteremia continues to be a common occurrence in patients with arteriovenous fistulas who are undergoing long-term hemodialysis, the complications and outcome of 37 episodes of bacteremia were examined. Systemic complications included pulmonary emboli, empyema, persistent bacteremia, and endocarditis. Such events were rarely life threatening—three of the 34 episodes involving patients without severe concurrent medical problems resulted in death. Local complications at the fistula site were common; however, thrombosis, hemorrhage, impending rupture, and persistent bacteremia caused loss of fistula in 13 of the 22 episodes seen with fistula inflammation. Results of this study demonstrate that, although loss of vascular access was an important problem, particularly in patients with prosthetic grafts, patients with S aureus bacteremia who were undergoing long-term hemodialysis had a favorable prognosis for survival, particularly when they were compared with other patients not undergoing hemodialysis. (Arch Intern Med 1982;142:1655-1658) References 1. Dobkin JF, Miller MH, Steigbigel NH: Septicemia in patients on chronic hemodialysis. Ann Intern Med 1978;88:28-33.Crossref 2. Linneman CC, McKee E, Laver MC: Staphylococcal infections in a hemodialysis unit. Am J Med Sci 1978;276:67-75.Crossref 3. Mennes PA, Gilula LA, Anderson CB, et al: Complications associated with arteriovenous fistulas in patients undergoing chronic hemodialysis. Arch Intern Med 1978;138:1117-1121.Crossref 4. Nsouli KA, Lazarus JM, Schoenbaum SC, et al: Bacteremic infection in hemodialysis. Arch Intern Med 1979;139:1255-1258.Crossref 5. Septicaemia in dialysis patients, editorial. Lancet 1980;1:521-522. 6. Bierman MH, Needham-Walker CA, Hammeke M, et al: Vancomycin therapy for serious staphylococcal infections in chronic hemodialysis patients. J Dial 1980;4:179-184. 7. Gombos EA, Jefferson DM, Bhat JG: Effect of hemodialysis on immune response. Proc Eur Dial Transplant Assoc 1975;11:367-374. 8. Greene WH, Casann RS, Mauer M, et al: The effect of hemodialysis on neutrophil chemotactic responsiveness. J Lab Clin Med 1976;88:971-974. 9. McIntosh J, Hansen P, Ziegler J, et al: Defective immune and phagocytic function in uremia and renal transplantation. Int Arch Allergy Appl Immunol 1976;51:544-550.Crossref 10. Cross AS, Steigbigel RT: Infective endocarditis and access site infections in patients on hemodialysis. Medicine 1976;55:453-466.Crossref 11. Nolan CM, Beaty HN: Staphylococcus aureus bacteremia. Am J Med 1976;60:495-502.Crossref 12. Iannini PB, Crossley K: Therapy of Staphylococcus aureus bacteremia associated with a removable focus of infection. Ann Intern Med 1976;84:558-563.Crossref 13. Watanakunakorn C, Baird IM: Staphylococcus aureus bacteremia and endocarditis associated with a removable infected intravenous device. Am J Med 1977;63:253-256.Crossref 14. Shah M, Watanakunakorn C: Changing patterns of Staphylococcus aureus bacteremia. Am J Med Sci 1979;278:115-121.Crossref 15. Smith I: Staphylococcus aureus , in Mandell GL, Douglas RG, Bennett JE (eds): Principles and Practice of Infectious Diseases . New York, John Wiley & Sons Inc, 1979, pp 1530-1552. 16. Banks T, Fletcher R, Ali N: Infective endocarditis in heroin addicts. Am J Med 1973;55:444-452.Crossref 17. Leonard A, Comty CM, Shapiro FL, et al: Osteomyelitis in hemodialysis patients. Ann Intern Med 1973;78:651-656.Crossref 18. Goodwin NJ, Castronuovo JJ, Friedman EA: Recurrent septic pulmonary embolization complicating maintenance hemodialysis. Ann Intern Med 1969;71:29-38.Crossref 19. Nicholls A, Edward N, Catto GRD: Staphylococcal septicemia, endocarditis, and osteomyelitis in dialysis and renal transplant patients. Postgrad Med J 1980;56:642-648.Crossref 20. Kirmani N, Tuazon CU, Murray HW, et al: Staphylococcus aureus carriage rate of patients receiving long-term hemodialysis. Arch Intern Med 1978;138:1657-1659.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Sep 1, 1982

References