Black and Hispanic patients on dialysis are at greater risk of dangerous blood infections

CNN
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According to a new Vital Signs report from the US Centers for Disease Control and Prevention, patients with failing kidneys who need regular dialysis treatments still have astronomical rates of dangerous staph infections in their blood compared to people who do not need these treatments. Infection rates are particularly high among people who are black or Hispanic or who have lower socioeconomic status, the report said.

More than half a million Americans rely on regular dialysis treatments to filter toxins from their blood because their kidneys no longer work as well as they should. Dialysis relies on the use of catheters and needles that circulate a patient’s blood through a machine in order to clean it.

“Germs like staph can enter the patient’s bloodstream through these access points,” Dr. Debra Houry, the CDC’s acting senior deputy director, said at a press conference Monday. “These infections can be serious or life-threatening, and some are resistant to some of the most commonly used antibiotics to treat them.”

The study shows that between 2017 and 2020, patients on hemodialysis had an annual rate of bloodstream infections caused by Staphylococcus aureus bacteria that was 100 times higher than adults not on dialysis – 4,248 infections per 100,000 years. people versus 42 per 100,000 person-years, respectively.

Of nearly 15,000 bloodstream infections reported to the government’s National Healthcare Safety Network in 2020, about one in three were caused by Staphylococcus aureus, and about a third of those were caused by antibiotic-resistant bacteria.

The study found that the type of access used for dialysis was also important. Patients who were connected to the machine via a central venous catheter had a higher risk of infection. With the catheter, a thin tube is inserted directly into a vein, usually in the neck or chest; the other end remains outside the body and is exposed to germs.

“Our data support that this use of a central venous catheter as a type of vascular access has a six-fold higher risk of staph bloodstream infections, compared to lower-risk, lower-risk fistula access” , said the study’s author, Dr. Shannon Novosad, leader of the dialysis safety team, told the CDC’s Division of Health Care Quality and Promotion in the briefing.

These dialysis-related blood infections disproportionately affect black and Hispanic adults, as they are at higher risk for kidney disease due to higher rates of diabetes and hypertension.

“Overall, for Hispanic patients after adjusting for other factors, we found a 40% higher risk of bloodstream infection for this group,” Novosad said.

The study also found that these infections were associated with lower socioeconomic status. Patients who progress to end-stage renal disease often have difficulty accessing primary care to manage their chronic conditions.

According to the study authors, dialysis-associated staph infections dropped by 40% between 2014 and 2019, but the study shows there is still a long way to go to make dialysis treatments safer for people. patients who need it.