Introduction:

Methicillin-resistant Staphylococcus aureus is the leading cause of catheter-related bacteremia in patients with advanced chronic kidney disease undergoing hemodialysis.

Objective:

Estimate the incidence rate of catheter-related bacteremia by methicillin-resistant Staphylococcus aureus in patients with advanced chronic kidney disease from General Freyre de Andrade Hospital in Cuba, and survey the vancomycin minimum inhibitory concentration values for isolates obtained from bacteremia.

Methods:

A study was conducted of 64 patients with methicillin-resistant Staphylococcus aureus (total of those undergoing hemodialysis) from May 2017 to February 2018. For each one of them, information was collected about vascular access type and time of use. Blood culture samples were obtained from patients who developed an episode suggesting bacteremia. Catheter-related bacteremia was reported using Bouza et al (2004) criteria, and it was confirmed as due to methicillin-resistant Staphylococcus aureus after determining oxacillin minimum inhibitory concentration by broth microdilution and CLSI 2017 criteria. Vancomycin minimum inhibitory concentration was also evaluated.

Results:

The incidence rates for catheter-related bacteremia by S. aureus and methicillin-resistant Staphylococcus aureus were 0.66 and 0.59/1000 catheter-days, respectively. A predominance was found of catheter-related bacteremia in patients with temporary vascular accesses. No increase was observed in vancomycin minimum inhibitory concentration (1 and 2 g/mlL for the isolates responsible for recurrent and persistent bacteremia.

Conclusions:

The incidence rates for catheter-related bacteremia show that good clinical practices are maintained in the hemodialysis unit. Vancomycin minimum inhibitory concentration values suggest a decrease in the efficacy of the drug during treatment.

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