Catheter-related bloodstream infection in end-stage kidney disease: a Canadian narrative review

Table 4 Treatment failure from bacteremia recurrence and complications with CRBSI with different management strategies [25, 26] (adapted)

Treatment Strategy	Treatment Failure (%)	Infectious Complications^d (%)	Septic Death (%)
Salvage (6-wks IV antibiotics)^a	26–33	2–13	6
Immediate Catheter Replacement^b(2-wks IV antibiotics)	3	3	0
Removal with Delayed Replacement^c	11	5	4
Changed Access Type	5	9	2
ANOVA significance (P-value)	0.002	0.33	0.45

^aSalvage was only attempted in CRBSI where clinical presentation was not severe (defined as no features of severe sepsis) and where adequate treatment response was observed within 48 hours of antibiotic initiation (defined as being afebrile with resolution of symptoms). ^bRemoval and over-wire exchange or new site within 24-48 hours of development of severe features of infection; re-implantation was done without waiting for blood culture negativity. ^cDelayed re-implantation of catheter for a minimum 1-week interval after culture negativity observed. ^dInfectious complications included septic pulmonary emboli, abscess, and osteomyelitis

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