Objective
The aim of this study was to assess microorganisms associated with vascular access–associated
infections (VAIs) in hemodialysis patients, with respect to possible origin from the
mouth.
Study Design
A retrospective and comparative analysis of the microbes associated with VAI in hemodialysis
patients treated during a 10-year period was performed with the Human Oral Microbiome
Database (HOMD).
Results
Of 218 patient records identified, 65 patients collectively experienced 115 VAI episodes.
The most common microorganisms involved were Staphylococcus aureus (49.6% of infections), Staphylococcus epidermidis (10.4%), Serratia marcescens (10.4%), Pseudomonas aeruginosa (9.6%), and Enterococcus faecalis/fecum (8.7%). None of these was found in ≥1% of HOMD clone libraries, indicating that they
very rarely colonize the teeth or plaque.
Conclusions
Most VAIs were associated with microorganisms more likely to originate from other
body sites than from the oral cavity. The risk of a VAI being caused by microorganisms
originating from the oral cavity is very small.
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References
- (Pradeep Arora M. Vecihi Batuman M, editors. Chronic kidney disease. Updated March 28, 2012) (Retrieved April 13, 2012)
- Annual data report: atlas of chronic kidney disease and end-stage renal disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases.http://www.usrds.org/qtr/default.aspx(Retrieved November 25, 2011)Date: 2011
- New national surveillance system for hemodialysis-associated infections: initial results.Am J Infect Control. 2002; 30: 288-295
- Infections in patients with end-stage renal disease.Infect Dis Clin North Am. 2001; 15 (vii): 709-720
- Preoperative vancomycin prophylaxis decreases incidence of postoperative hemodialysis vascular access infections.Am J Kidney Dis. 1997; 30: 343-348
- The evidence base for the efficacy of antibiotic prophylaxis in dental practice.J Am Dent Assoc. 2007; 138: 458-474
- Oral microflora as a cause of endocarditis and other distant site infections.Infect Dis Clin North Am. 1999; 13: 833-850
- Nonvalvular cardiovascular device–related infections.Circulation. 2003; 108: 2015-2031
- Decision-making on the use of antimicrobial prophylaxis for dental procedures: a survey of infectious disease consultants and review.Clin Infect Dis. 2002; 34: 1621-1626
- Dialysis events.(Retrieved December 20, 2011)
- The Human Oral Microbiome Database: a web accessible resource for investigating oral microbe taxonomic and genomic information.doi:10.1093/database/baq013(Retrieved December 28, 2010)Date: 2010
- Characterization of the oral fungal microbiome (mycobiome) in healthy individuals.PLoS Pathog. 2010; 6: 1-8
- Characterization of yeasts colonizing in healthy individuals.Med Mycol. 2011; 49: 103-106
- The human oral microbiome.J Bacteriol. 2010; 192: 5002-5017
- Clinical management of dialysis catheter-related bacteremia with concurrent exit-site infection.Semin Dial. 2011; 24: 239-241
- Clinical consequences of infected arteriovenous grafts in hemodialysis patients.Am J Kidney Dis. 2001; 38: 975-978
- Skin microflora and bacterial infections of the skin.J Investig Dermatol Symp Proc. 2001; 6: 170-174
- An analysis of bacteremias during dental extractions.Arch Intern Med. 1996; 156: 513-520
- Relationship between oral bacteria and hemodialysis access infection.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 98: 418-422
- Identification of oral bacteria in blood cultures by conventional versus molecular methods.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 105: 720-724
Article info
Publication history
Accepted:
August 11,
2012
Received in revised form:
August 8,
2012
Received:
May 18,
2012
Footnotes
Supported by National Institutes of Health grant K23DE016946.
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
