RESUMEN
BACKGROUND: A significant number of patients require non-tunneled haemodialysis catheters (NTHCs) in the event of an urgent need for immediate haemodialysis in developing countries. Catheter-related bloodstream infections (CRBSIs) are a major concern in haemodialysis, but there is a lack of local epidemiological data. This study aimed to determine the incidence of CRBSI, causative agents and associated risk factors in a tertiary care hospital in Sri Lanka. METHODS: A prospective study was conducted at the dialysis unit of Colombo South Teaching Hospital, Sri Lanka from December 2019 to August 2020. Adult patients who had haemodialysis for the first time with NTHCs were included. RESULTS: Of 149 dialysis patients (104-jugular vein and 45-femoral vein, mean age 58 ± 13.7 years, mean duration of catheterization 7.9 ± 3.4 days), the incidence of CRBSI was 13.58 per 1000 catheter days. Serum albumin levels, capillary blood sugar levels at admission, haemoglobin levels and duration of catheterization were significantly associated with CRBSI. Prescence of diabetes and patients with ESRD who started routine haemodialysis had a significantly higher risk of CRBSI. Gram-positive bacteria were the most common microorganisms associated with CRBSI (87.5%). CONCLUSIONS: Our results show high rates of infection with temporary vascular catheters in Sri Lanka, mainly due to Gram-positive bacteria. Diabetes mellitus, duration of catheterisation, low serum albumin, haemoglobin level and CBS on admission were identified as significant risk factors for CRBSI. Management strategies tailored to specific centers should be established in the nation to optimise catheter care and to monitor local microbiology for appropriate empirical antimicrobial treatment.
Asunto(s)
Infecciones Relacionadas con Catéteres , Diálisis Renal , Centros de Atención Terciaria , Humanos , Sri Lanka/epidemiología , Persona de Mediana Edad , Masculino , Estudios Prospectivos , Diálisis Renal/efectos adversos , Diálisis Renal/instrumentación , Femenino , Infecciones Relacionadas con Catéteres/epidemiología , Infecciones Relacionadas con Catéteres/etiología , Infecciones Relacionadas con Catéteres/microbiología , Factores de Riesgo , Incidencia , Anciano , Fallo Renal Crónico/terapia , Adulto , Bacteriemia/epidemiología , Bacteriemia/etiología , Cateterismo Venoso Central/efectos adversos , Factores de Tiempo , Albúmina Sérica/análisis , Hemoglobinas/análisis , Catéteres Venosos Centrales/efectos adversos , Catéteres Venosos Centrales/microbiologíaRESUMEN
Introduction: Parents with cancer children face multiple and unexpected difficulties and apply coping strategies to minimize stressful conditions. The objective of this study was to assess maternal coping strategies in response to their children with cancer in Sri Lanka.Material and methods: A cross-sectional study was conducted among 200 mothers having children with cancers. Coping Health Inventory for Parents instrument was used to collect information about coping strategies.Results: More than 75% children were diagnosed as cancer more than 6 months before when starting this study. Maintaining family integration, cooperation, optimistic definition of the situation was the most helpful coping strategy while seeking medical helps through communication with parents and consultation with medical staff was the least helpful coping strategy among mothers. Gender of the child and current condition of the disease were significantly associated with social support and medical support. Type of disease was significantly associated with family support and the number of other children per mother was significantly associated with social support.Conclusions: Relaxation and counseling programs to modify less desirable coping strategies are emphasized for mothers who were with cancer children. More researches need to identify coping strategies and its impact on psychological and physical adjustment as well.