Hemodialysis Central Venous Catheter‐Related Bacteremia: Time to Onset
Bibliographic record
Abstract
Bacteremia (B) is a well‐known complication of an indwelling central venous catheter (CVC). Although prophylactic measures such as topical and catheter lock antibiotics have been demonstrated to decrease the risk of B in hemodialysis (HD) in patients with a CVC, there are concerns about the development of resistance to these agents when used for long periods of time. Objective: We wondered if we could limit the use of these agents by identifying the period when B was most common after CVC placement. Method: We prospectively noted all patients with a CVC who developed B in any of our 3 units in CT, U.S.A.; 62 episodes of B occurred between 1/1/03 and 9/18/03. 35% of all of the HD patients had a CVC for access during the study period. Results: Staphylococcus aureus accounted for 22 (35.5%) episodes; Gram‐negative organisms for 21 (33.8%) and other staphylococcal species for 14 (22.6%). The other 3 episodes were other Gram‐positive organisms and 6 patients developed B with more than 1 organism. 3 (4.8%) patients expired while being treated for the B. The average time to onset of B was 96 ± 98 CVC days with a range of 1–365 days. There was no difference in time to onset based on organism. 43.5% of the episodes of B occurred less than 60 days after the CVC was inserted, but 27.4% occurred greater than 100 days after CVC insertion. Conclusion: The time to onset of CVC‐related B was variable among the patients developing B in this study. Preventative strategies aimed at reducing the risk of B in patients with a CVC must be used for the life of the CVC.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".