Outcome following haemodialysis catheter-related Staphylococcus aureus bacteraemia

Staphylococcus aureus is a frequent cause of haemodialysis access-related b acteraemia. The propensity for this organism to seed from the bloodstream t o distant sites is well recognized, but the rate at which this occurs is po orly defined in patients with removable haemodialysis catheters. This retro spective study identified 47 patients with 50 episodes of S. aureus haemodi alysis catheter-related bacteraemia between August 1993 and December 1995. Adverse events were recorded until February 1996. Thirty of 50 episodes (60 %) were apparently uncomplicated. Bacterial seeding to heart valves or dist ant sites was documented in eight episodes (16%), of which six occurred dur ing antibiotic therapy. A further 12 patients had persistent bacteraemia in the absence of a defined focus of infection, the last positive blood cultu re ranging from 2-19 days (mean 6.6, median 5) after removal of the haemodi alysis catheter and commencing appropriate antibiotic treatment. The seriou s nature of this infection confirms the need for prevention, together with effective strategies for investigation and treatment in this patient popula tion.