혈액투석과 연관된 균혈증 = Bacteremia in Patients on Hemodialysis

국문 초록 (Abstract)

만성신부전 환자에서 감염의 위험이 높고 또한 주요한 사망의 원인이라는 것은 널리 알려진 사실이다. 만성신부전 환자 중에서 혈액투석 환자들은 잦은 투석용 혈관의 천자와 삽입된 도관 때문에 혈관 통로를 통한 감염의 위험에 항상 노출되어 있다. 환자 본인의 정맥을 이용하여 만든 자가 동정맥루 이외의 인조 혈관과 중심정맥 도관은 감염의 위험이 순차적으로 더욱 높다1). 혈액투석의 혈관 통로를 통한 감염은 바로 균혈증으로 이어지기 때문에, 환자의 이환과 사망에 직결된다.

참고문헌 (Reference)

1 "우리나라 신대체 요법의 현황" 22 (22): 353-368, 2003

2 "The impact of nasal carriage of methicillin-resistant and methicillin-susceptible Staphylococcus aureus (MRSA & MSSA) on vascular access-related septicemia among patients with type-II diabetes on dialysis" 24 : 763-777, 2002

3 "Septicemia in dialysis patients : incidence, risk factors, and prognosis" 55 : 1081-1090, 1999

4 "Risk of bacteremia from temporary hemodialy sis catheters by site of insertion and duration of use : a prospective study" 58 : 2543-2545, 2000

5 "Reduction of Staphylococcus aureus nasal carriage and infection in dialysis patients" 40 : 13-23, 1998

6 "Prevention of hemodialysis catheter-related bloodstream infection using an antimicrobial lock" 20 : 87-92, 2002

7 "Preventing bacterial infections and antimicrobial resistance in dialysis patients" 40 : 886-898, 2002

8 "New national surveillance system for hemodialysis-associated infections : initial results" 30 : 288-295, 2002

9 "National surveillance of dialysis-associated diseases in the United States, 2001" 17 : 310-319, 2004

10 "Linezolid compared with eperezolid, vancomycin, and gentamicin in an in vitro model of antimicrobial lock therapy for Staphylococcus epidermidis central venous catheter-related biofilm infections" 47 : 3145-3148, 2003

11 "III. NKF-K/DOQI Clinical Practice Guidelines for Vascular Access : update 2000" 37 (37): 137-181, 2001

12 "EPIBACDIAL : a multicenter prospective study of risk factors for bacteremia in chronic hemodialysis patients" 9 : 869-876, 1998

13 "Compared to tunnelled cuffed haemodialysis catheters, temporary untunnelled catheters are associated with more complications already within 2 weeks of use" 19 : 670-677, 2004

14 "Canadian Nosocomial Infection Surveillance Program; Canadian Hospital Epidemiology Committee : Incidence of bloodstream infection in multicenter inception cohorts of hemodialysis" 32 : 155-160, 2004