Septicaemia in a renal unit
BACTERIAL sepsis in the patient with renal failure has serious consequences. Medical records of 30 patients who had positive blood cultures from July 1979 to June 1980 were reviewed. Six cases were not significant. In the remaining 24 patients, 30 septicaemic episodes were identified. Eleven of the patients were on maintenance haemodialysis and had 14 staphylococcal septicaemias. Ten patients were post transplant and had 12 septicaemic episodes due to both gram-positive cocci and gram negative bacilli. Three patients who had chronic renal failure and were not on dialysis, had 3 gram negative septicaemias. Thirteen patients had staphyloccal septicaemia due in 11 cases to infection at vascular access sites. Three patients died (mortality 23%). Seven patients had gram negative septicaemia which was urinary tract in all cases with 2 deaths (mortality 28%).
Fifty-two patients received transplants in the period studied and 10 patients developed septicaemia (19%) and of those patients 5 died. Mortality and morbidity increased with the progressive combination of uraemia, haemodialysis and immunosuppression.
KeywordsChronic Renal Failure Positive Blood Culture Rejection Episode Post Transplant Renal Unit
Bjorksten, B., Maher, S. M., Mills, E. I., Quie, P. G. 1978. The effect of haemodialysis on neutrophil chemotactic responsiveness. Acta Med. Scand. 203, 67.PubMedGoogle Scholar
Boulton-Jones, T. M., Vick, R, Cameron, J. S. 1973. Immune response in uraemia. Clin. Nephrol. 1, 351.PubMedGoogle Scholar
Brescia, M. J., Cimino, J. E., Appel, K., Hurwick, B. J. 1966. Chronic haemodialysis using venepuncture and a surgically created anteriovenous fistula. N. Engl. J. Med. 275, 1089.PubMedGoogle Scholar
Bryant, R. E., Hood, A. F., Hood, C. E., Koenig, M. G. 1971. Factors affecting mortality of gram negative rod bacteraemia. Arch Intern. Med. 127, 120.PubMedCrossRefGoogle Scholar
Dobkin, J. F., Miller, M. H., Steigbigel, N. H. 1978. Septicaemia in patients on chronic haemodialysis. Ann. Intern Med. 88, 28.PubMedGoogle Scholar
Fried, M. A., Vosti, K. L. 1968. The importance of underlying disease in patients with gram negative bacteraemia. Arch. Intern. Med. 121, 418.CrossRefGoogle Scholar
Hanson, S., Carmody, M., Keogh, B., O’Dwyer, W. F. 1967. Access to circulation by permanent anteriovenous fistula in regular dialysis treatments. Brit. Med. J. iv, 586–589.CrossRefGoogle Scholar
Kreger, B. E., Craven, D. E., Carling, P. C, McCabe, W. F. 1980. Gram Negative Bacteraemia III reassessment of etiology epidemiology and ecology in 612 patients. Am. J. Med. 68, 332.PubMedCrossRefGoogle Scholar
McCabe, W. R., Jackson, G. G. 1962. Gram negative bacteraemia. Arch. Intern. Med. 110, 847.Google Scholar
Sham, M., Watanakunakorn, C. 1979. Changing patterns of staphylococcal bacteraemia. Am. J. Med. Sci. 278, 115.CrossRefGoogle Scholar
Wilson, W. E. C., Kirkpatrick, C. H., Talmage, D. W. 1965. Suppression of immunologie responsiveness in uraemia. Ann. Intern. Med. 62, 1.Google Scholar