Catheter-related bloodstream infections in hemodialysis: a systematic review and meta-analysis of prevalence and risk

Abstract

Introduction: This study aims to identify and systematically assess the prevalence of Catheter-related bloodstream infections (CRBSI) and identify risk factors of CRBSI in hemodialysis (HD) patients.

Methodology: A comprehensive literature review was conducted to identify pertinent studies related to the prevalence of CRBSI and risk factors of CRBSI in HD patients. This involved searching widely recognized electronic databases with MeSH terms to retrieve relevant studies. Relevant articles were screened, duplicates were removed, eligibility criteria were applied, and studies that met the criteria were reviewed. Prevalence of CRBSI was pooled using a random effect model using Comprehensive Meta-Analysis (CMA) software.

Results: From the initial search across four electronic databases, a total of 1850 studies were identified. After eliminating 1615 duplicate studies, 235 remained for screening. Of these, 180 were excluded due to the lack of relevant terms. Of the 55 studies left, 43 were not included due to a lack of relevant data. Finally, the pooled combined prevalence across these 12 studies was 22.8% (95% CI of 0.117 to 0.397), whereas the I-squared value obtained is 99.38%. Regionally, prevalence in Asia was 17.5% (95% CI of 0.046 to 0.483), while in Africa it was 30.4% (95% CI of 0.240 to 0.376). The most common risk factors identified were immunocompromised status, along with comorbidities such as hypertension and diabetes mellitus, previous catheter insertion, and prolonged hospital stays.

Conclusions: The findings of this review indicate that CRBSI is a serious issue faced by HD patients, especially those with the commonly identified risk factors.