Abstract:

Background: Infections are the second leading cause of death among other complications in patients undergoing dialysis. They can kill, disable, hospitalize, or prolong illness in patients and so increasing the cost for treatment. Infections in hemodialysis may be due to many causes including the fast turn over between dialysis sessions and immunity. The burden of infections seems to be large and treatment options are limited and costly. Also, little is known about the burden and patterns of infections. Therefore this study will help us to determine the prevalence, patterns of blood stream infection and associated factors among patients undergoing hemodialysis at Bugando medical centre and so help to advocate early prevention so as reduce the burden and also to reduce morbidity and mortality.

Methodology: This was a hospital quantitative cross-sectional study conducted among patients undergoing hemodialysis at Bugando medical centre and involved 182 participants. The sample was collected by taking a swab of the catheters for both naïve patients and the on-going patients then followed by doing culture. The collected data was analyzed by using SPSS software, version 20. Chi square test was used to analyze the statistical association and the p-value of less than 0.05 was considered significant for predictors of associated factors in patients undergoing hemodialysis. Ethical clearance was sought from the Joint CUHAS Research Ethics Committee.

Results: A total number of 46 patients were enrolled in the study. Majority of the participants were males 33 (71.1%). The mean age of the participants was 47 years ranging from 19 years to 75 years. Majority of the participants were between 40 to 65 years accounting 26 (52.2%) only 4 participants (8.7%) claimed to have none or incomplete primary school and only 12 (26.1%) not employed or retired 35 (76.1%) had hypertension, 31 (67.4%) used alcohol, 17 (37%) had diabetes, 34 patients (73.9%) had chronic kidney disease meanwhile only 33 (71.7%) of the patients used Health Insurance Funds. Only 25 (54.3%) of the participants had blood culture results positive and different organisms were isolates. The most isolated organism was staphylococcus 13 to the 46 samples (28.3%) followed by gram negative Bacilli grew inn 6 sample (13.0%) other bacteria isolated were Enterobacter spp 2 Escherichia coli 3 (6.5%) and pseudomonas spp 1 (2.2%).

Conclusion: End stage renal disease is on the rise in among non-communicable disease, therefore requiring a major concern on different ways to halt the disease progression. Hemodialysis is an accessible modality of improving quality of life but also a bridge to definitive treatment which is renal transplant. In our low income countries it costs a lot to treat blood stream infections and also bills for patients’ hospitalization meanwhile it jeopardized quality of life. This study had tried to provide the descriptive analysis on the prevalence and pattern of blood stream infection with their associated factors among patients undergoing hemodialysis at Bugando medical centre and therefore.

Recommendation: Considering our study had incomplete data which could not therefore be used to statistically show the real prevalence of blood stream infection, patterns of infection (organisms involved) and associated factors in comparison to other studies and thus cannot be used to provide education, I recommend that this study should be further continued to complete the required data so as to find the statistical significance and association of different factors and therefore be used to provide education to the care taker on the increasing burden of blood stream infections in hemodialysis but also organisms commonly involved and their drug sensitivity in order to reduce antibiotics use that can also lead to increase in the drug resistance.