Abstract
Introduction: Despite all efforts to prevent tunneled-cuffed catheter (TCC) infection, the
incidence of this infection has remained considerably high.
Objectives: The present study aimed to assess risk determinants affecting TCC infection in
hemodialysis patients.
Patients and Methods: This case-control study was performed on 165 consecutive patients as
known cases of end-stage renal disease on maintenance hemodialysis through double-lumenTCC.
The patients were assigned into two groups as the case group with the clinical evidences
of TCC infection and the control group with noninfectious condition.
Results: In the group with TCC infection, the most common microorganisms cultured in
the medium included Staphylococcus aurous and Staphylococcus epidermidis with the overall
prevalence of 17.6% and 15.3% in blue lumen and 14.1% and 14.1% in red lumen, respectively.
Overall, 75.3% of the lumens were positive for infection, while 52.9% of blood cultures were
positive. Multivariable logistic regression modeling showed that female gender, insertion
catheter through jugular vein, higher C-reactive protein (CRP) level, lower serum iron level
and higher serum ferritin level could predict TCC infection in dialysis patients. According
to ROC curve analysis, measuring CRP level, serum iron and serum ferritin could effectively
discriminate TCC infection from noninfectious condition. Particularly, serum CRP >16 mg/
dL, ferritin > 200 ng/mL and serum iron <40 mg/dL could predict TCC infection.
Conclusion: Around 75% of samples extracted from catheter lumens are positive for TCC
infection. The main determinants of TCC infection included female gender, insertion catheter
by jugular vein, higher CRP level, lower serum iron level, and higher serum ferritin level.