Changes in vascular accesses and in incidence rates of dialysis-related bloodstream infections in Québec, Canada, 2011-2017
Surveillance of dialysis-related bloodstream infections (DRBSIs) has been mandatory in Québec since April 2011. The aim of this study was to describe the epidemiology of DRBSIs in Québec. Cohort study of prevalent patients undergoing chronic dialysis in the 36 facilities that participated without in...
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| Veröffentlicht in: | Infection control and hospital epidemiology 2019-06, Vol.40 (6), p.627-631 |
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| creator | Fortin, Élise Ouakki, Manale Tremblay, Claude Villeneuve, Jasmin Desmeules, Simon Parisien, Natasha Moisan, Danielle Frenette, Charles |
| description | Surveillance of dialysis-related bloodstream infections (DRBSIs) has been mandatory in Québec since April 2011. The aim of this study was to describe the epidemiology of DRBSIs in Québec.
Cohort study of prevalent patients undergoing chronic dialysis in the 36 facilities that participated without interruption in the provincial surveillance, between April 2011 and March 2017. Two indicators were analyzed: proportion of patient months dialyzed using a fistula (a patient month is a 28-day cycle during which an individual patient received dialysis) and incidence rate of DRBSI. Binomial and Poisson regression with generalized estimating equations were used to describe the evolution of indicators over time and to quantify the association between facilities' proportion of fistulas and their incidence rate.
Globally, 42.6% of all patient months were dialyzed using a fistula, but there was a statistically significant decrease over time (46.2% in 2011-2012 to 39.3% in 2016-2017). Despite this decline in the use of fistulas, rates of DRBSIs have also decreased, going from 0.38 DRBSIs per 100 patient months in 2011-2012 to 0.23 DRBSIs per 100 patient months in 2016-2017. No association was found between facility use of fistulas and the rate of DRBSI. At the individual level, however, the DRBSI rate was 4.12 times higher for patients using a catheter.
In Québec, the rate of DRBSIs has decreased over a 6-year period despite an increasing proportion of patients dialyzed by catheter. |
| doi_str_mv | 10.1017/ice.2019.65 |
| format | Article |
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Cohort study of prevalent patients undergoing chronic dialysis in the 36 facilities that participated without interruption in the provincial surveillance, between April 2011 and March 2017. Two indicators were analyzed: proportion of patient months dialyzed using a fistula (a patient month is a 28-day cycle during which an individual patient received dialysis) and incidence rate of DRBSI. Binomial and Poisson regression with generalized estimating equations were used to describe the evolution of indicators over time and to quantify the association between facilities' proportion of fistulas and their incidence rate.
Globally, 42.6% of all patient months were dialyzed using a fistula, but there was a statistically significant decrease over time (46.2% in 2011-2012 to 39.3% in 2016-2017). Despite this decline in the use of fistulas, rates of DRBSIs have also decreased, going from 0.38 DRBSIs per 100 patient months in 2011-2012 to 0.23 DRBSIs per 100 patient months in 2016-2017. No association was found between facility use of fistulas and the rate of DRBSI. At the individual level, however, the DRBSI rate was 4.12 times higher for patients using a catheter.
In Québec, the rate of DRBSIs has decreased over a 6-year period despite an increasing proportion of patients dialyzed by catheter.</description><identifier>ISSN: 0899-823X</identifier><identifier>EISSN: 1559-6834</identifier><identifier>DOI: 10.1017/ice.2019.65</identifier><identifier>PMID: 30957725</identifier><language>eng</language><publisher>United States: Cambridge University Press</publisher><subject>Aged ; Ambulatory care ; Bacteremia - epidemiology ; Bacteremia - etiology ; Bacteremia - prevention & control ; Catheter-Related Infections - epidemiology ; Catheter-Related Infections - etiology ; Catheter-Related Infections - prevention & control ; Catheters ; Cohort Studies ; Cross Infection - epidemiology ; Cross Infection - etiology ; Cross Infection - prevention & control ; Dialysis ; Epidemiology ; Female ; Fistula ; Forecasting ; Hemodialysis ; Humans ; Incidence ; Infection Control - methods ; Infections ; Male ; Medical instruments ; Microorganisms ; Nursing ; Patients ; Quebec - epidemiology ; Ratios ; Regression Analysis ; Renal Dialysis - adverse effects ; Renal Dialysis - statistics & numerical data ; Surveillance ; Trends</subject><ispartof>Infection control and hospital epidemiology, 2019-06, Vol.40 (6), p.627-631</ispartof><rights>2019 by The Society for Healthcare Epidemiology of America. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c317t-f51c2720f3e5f723e7d09e44fd24fe9730a011cd22c52a061d6a5639b9b4576f3</citedby><cites>FETCH-LOGICAL-c317t-f51c2720f3e5f723e7d09e44fd24fe9730a011cd22c52a061d6a5639b9b4576f3</cites><orcidid>0000-0001-6612-9091</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2787895383/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2787895383?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,21388,21389,23256,27924,27925,33530,33531,33703,33704,33744,33745,43659,43787,43805,64385,64387,64389,72469,74104,74283,74302</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30957725$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fortin, Élise</creatorcontrib><creatorcontrib>Ouakki, Manale</creatorcontrib><creatorcontrib>Tremblay, Claude</creatorcontrib><creatorcontrib>Villeneuve, Jasmin</creatorcontrib><creatorcontrib>Desmeules, Simon</creatorcontrib><creatorcontrib>Parisien, Natasha</creatorcontrib><creatorcontrib>Moisan, Danielle</creatorcontrib><creatorcontrib>Frenette, Charles</creatorcontrib><creatorcontrib>for SPIN-BAC-HD</creatorcontrib><creatorcontrib>for SPIN-BAC-HD</creatorcontrib><title>Changes in vascular accesses and in incidence rates of dialysis-related bloodstream infections in Québec, Canada, 2011-2017</title><title>Infection control and hospital epidemiology</title><addtitle>Infect Control Hosp Epidemiol</addtitle><description>Surveillance of dialysis-related bloodstream infections (DRBSIs) has been mandatory in Québec since April 2011. The aim of this study was to describe the epidemiology of DRBSIs in Québec.
Cohort study of prevalent patients undergoing chronic dialysis in the 36 facilities that participated without interruption in the provincial surveillance, between April 2011 and March 2017. Two indicators were analyzed: proportion of patient months dialyzed using a fistula (a patient month is a 28-day cycle during which an individual patient received dialysis) and incidence rate of DRBSI. Binomial and Poisson regression with generalized estimating equations were used to describe the evolution of indicators over time and to quantify the association between facilities' proportion of fistulas and their incidence rate.
Globally, 42.6% of all patient months were dialyzed using a fistula, but there was a statistically significant decrease over time (46.2% in 2011-2012 to 39.3% in 2016-2017). Despite this decline in the use of fistulas, rates of DRBSIs have also decreased, going from 0.38 DRBSIs per 100 patient months in 2011-2012 to 0.23 DRBSIs per 100 patient months in 2016-2017. No association was found between facility use of fistulas and the rate of DRBSI. At the individual level, however, the DRBSI rate was 4.12 times higher for patients using a catheter.
In Québec, the rate of DRBSIs has decreased over a 6-year period despite an increasing proportion of patients dialyzed by catheter.</description><subject>Aged</subject><subject>Ambulatory care</subject><subject>Bacteremia - epidemiology</subject><subject>Bacteremia - etiology</subject><subject>Bacteremia - prevention & control</subject><subject>Catheter-Related Infections - epidemiology</subject><subject>Catheter-Related Infections - etiology</subject><subject>Catheter-Related Infections - prevention & control</subject><subject>Catheters</subject><subject>Cohort Studies</subject><subject>Cross Infection - epidemiology</subject><subject>Cross Infection - etiology</subject><subject>Cross Infection - prevention & control</subject><subject>Dialysis</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Fistula</subject><subject>Forecasting</subject><subject>Hemodialysis</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infection Control - methods</subject><subject>Infections</subject><subject>Male</subject><subject>Medical instruments</subject><subject>Microorganisms</subject><subject>Nursing</subject><subject>Patients</subject><subject>Quebec - 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Academic</collection><jtitle>Infection control and hospital epidemiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fortin, Élise</au><au>Ouakki, Manale</au><au>Tremblay, Claude</au><au>Villeneuve, Jasmin</au><au>Desmeules, Simon</au><au>Parisien, Natasha</au><au>Moisan, Danielle</au><au>Frenette, Charles</au><aucorp>for SPIN-BAC-HD</aucorp><aucorp>for SPIN-BAC-HD</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Changes in vascular accesses and in incidence rates of dialysis-related bloodstream infections in Québec, Canada, 2011-2017</atitle><jtitle>Infection control and hospital epidemiology</jtitle><addtitle>Infect Control Hosp Epidemiol</addtitle><date>2019-06</date><risdate>2019</risdate><volume>40</volume><issue>6</issue><spage>627</spage><epage>631</epage><pages>627-631</pages><issn>0899-823X</issn><eissn>1559-6834</eissn><abstract>Surveillance of dialysis-related bloodstream infections (DRBSIs) has been mandatory in Québec since April 2011. The aim of this study was to describe the epidemiology of DRBSIs in Québec.
Cohort study of prevalent patients undergoing chronic dialysis in the 36 facilities that participated without interruption in the provincial surveillance, between April 2011 and March 2017. Two indicators were analyzed: proportion of patient months dialyzed using a fistula (a patient month is a 28-day cycle during which an individual patient received dialysis) and incidence rate of DRBSI. Binomial and Poisson regression with generalized estimating equations were used to describe the evolution of indicators over time and to quantify the association between facilities' proportion of fistulas and their incidence rate.
Globally, 42.6% of all patient months were dialyzed using a fistula, but there was a statistically significant decrease over time (46.2% in 2011-2012 to 39.3% in 2016-2017). Despite this decline in the use of fistulas, rates of DRBSIs have also decreased, going from 0.38 DRBSIs per 100 patient months in 2011-2012 to 0.23 DRBSIs per 100 patient months in 2016-2017. No association was found between facility use of fistulas and the rate of DRBSI. At the individual level, however, the DRBSI rate was 4.12 times higher for patients using a catheter.
In Québec, the rate of DRBSIs has decreased over a 6-year period despite an increasing proportion of patients dialyzed by catheter.</abstract><cop>United States</cop><pub>Cambridge University Press</pub><pmid>30957725</pmid><doi>10.1017/ice.2019.65</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0001-6612-9091</orcidid></addata></record> |
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| source | ProQuest Central Essentials; MEDLINE; ProQuest Central (Alumni Edition); ProQuest Central UK/Ireland; ProQuest Central; Cambridge University Press Journals Complete |
| subjects | Aged Ambulatory care Bacteremia - epidemiology Bacteremia - etiology Bacteremia - prevention & control Catheter-Related Infections - epidemiology Catheter-Related Infections - etiology Catheter-Related Infections - prevention & control Catheters Cohort Studies Cross Infection - epidemiology Cross Infection - etiology Cross Infection - prevention & control Dialysis Epidemiology Female Fistula Forecasting Hemodialysis Humans Incidence Infection Control - methods Infections Male Medical instruments Microorganisms Nursing Patients Quebec - epidemiology Ratios Regression Analysis Renal Dialysis - adverse effects Renal Dialysis - statistics & numerical data Surveillance Trends |
| title | Changes in vascular accesses and in incidence rates of dialysis-related bloodstream infections in Québec, Canada, 2011-2017 |
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