Dr Lauren Bloomfield1,2, Dr Liana Varrone1, Ms. Melanie Trainor1, Ms. Lisa Nicolau1, Ms. Rebecca McCann1, Dr Jelena Matecevic1
1WA Department of Health, Perth, Australia, 2The University of Notre Dame Australia, Fremantle, Australia
Biography:
Dr Lauren Bloomfield is an Epidemiologist in the Communicable Disease Control Directorate, WA Department of Health. Her works covers all areas of communicable disease control, including immunisation, disease surveillance and nosocomial infections.
Abstract:
Introduction
Reporting of haemodialysis-access related bloodstream infections (HD-BSIs) to Healthcare Infection Surveillance Western Australia (HISWA) has been mandatory since July 2005. This analysis describes the epidemiology of HD-BSIs reported to HISWA between 1 July 2012 and 30 June 2023.
Methods
All HD-BSIs reported to HISWA reported from public and private haemodialysis centres were included. Home dialysis centres were excluded. A total of 25 dialysis centres contributed across the study period, the majority reported for all 10 years under study.
Results
The most common access type was arteriovenous fistula (AVF), contributing 75% of patient-months on average each year, followed by cuffed catheters (CC), contributing 22% of patient-months on average each year. There were no significant trends observed in the utilisation of AVF and CC over time.
Annual infection rates have fluctuated over time; the highest annual rate reported was in the 2013-14 initial reporting period (0.33 infections per 100 patient-months, CI95 0.24 – 0.47); the lowest rate reported was in 2019-20 (0.12, CI95 0.07 – 0.19) and the rate has increased year-on-year since this period to 0.28 infections per 100 patient months in 2022-23 (CI95 0.21 – 0.38).
There has been a recent upward trend in CC rates. Overall, The IRR for cuffed catheter access-related infections was ~18 times higher than for AVF access-related infections and this effect remained stable after controlling for reporting year.
Conclusion
Infection associated with CC access are higher and have recently been increasing in WA. Potential reasons for this increase will be explored in this presentation.