عزل وتوصيف البكتيريا المسببة لعدوى مجرى الدم المتعلقة بالقسطرة ودور الانترلوكين-10 في مرضى الفشل الكلوي المزمن مع غسيل الكلى

Isolation and characterization of causative bacteria of catheter related blood stream infection and the role of interleukin-10 in chronic renal disease patients on hemodialysis

Infection is a common complication and is the second leading cause of death in hemodialysis patients. The risk of bacteremia in hemodialysis patients is 26-fold higher than in the general population, and 1/2-3/4 of the causative organisms of bacteremia in hemodialysis patients are Gram-positive bacteria, hemodialysis patients have a higher risk of Staphylococcus infection and the most common site of infection causing bacteremia is internal prostheses.
The aims of the study are to Characterize and distribution of type of bacterial infection and antibiotic susceptibility test and the relationship of interleukin-10 with catheter related bloodstream infection.
The present study is designed to deal with blood Stream infection in hemodialysis Patient, after establishing the diagnosis via investigation and clinical diagnosis at the dialysis center in Imam AL-Hussein hospital in Kerbala province during the period from November 2022 to April 2023.
A total of (100) blood samples (70 patients and 30 controls), patients group sub divided 35 center venous catheter, 35 arteriovenous fistula), the age group varied from (10-80) year. Blood samples were collected with volume 10 ml, blood culture was done for bacterial isolation and identification, after that many analyses were performed, including kidney function test (urea, creatinine, sugar), immunological index (interleukin10), Microbiological test (Antibiotic susceptibility test).
The current study’s results show that bacterial infection occurs in 48.6% of center venous catheter patients, 8.6%of arteriovenous fistula patients, Staphylococcus epidermidis was the most bacterial species isolated from hemodialysis patients.
The results of antibiotic resistance show that (85.7%) from resistant to Ammoxillin and (14.3%) of Staphylococcus epidermidis resistant to Cefotaxime, Ceftriaxone, Meropeneme, Clindamycin, (100%) Staphylococcus aureus resistant to Ammoxillin, 80% resistant to Ceftriaxone, (60 %) resistant to Gentamycin, (40%) resistant to Cefotaxime, (20%) resistant to , Meropeneme ,( 80% )of Staphylococcus hominis resistant to Ammoxillin ,(60%), resistant to Gentamycin, Ceftriaxone (40%) resistant to Cefotaxime,( 20%) resistant to Piperacillin/Tazobactam, (100%) Escherichia Coli resistant to Cefotaxime , Ammoxillin (66.7%) resistant to Ceftriaxone, Clindamycin, (33.3%) resistant to Gentamycin.
The results showed that there was a significant difference in serum level at (P < 0.05) between interleukin-10 and infected and non-infected patients with bacteremia, where the concentration of IL-10 was high in patients with bacteremia compared to patients without bacteremia, and there was a significant difference between interleukin -10 and types of bacteria, as it was high in Escherichia coli bacteria with an average of (62.981), followed by Staphylococcus aureus bacteria with an average of (24.977) and then Staphylococcus Hominis with an average of (11,054) and Staphylococcus Epidermidis with an average (10,650).
The result concluded that patient with center venous catheter type was the most bacterial infection than arteriovenous fistula in and the most predominant bacterial was Staphylococcus epidermidis, and the most effective antibiotic was Imepeneme for gram-positive bacteria, Piperacillin/Tazobactam for gram negative bacteria, IL-10 was high in patients with bacterial infection compared to patients without bacterial infection.