Chronic kidney disease is a major public health problem, affecting approximately 700 million people worldwide. Data from the 2024 Brazilian dialysis census show an almost 10% increase in the estimated number of patients on dialysis in the country. Over the last 10 years, this number has grown by approximately 55%. The present study was conducted based on analysis of hospital infection reports from a tertiary hospital in the interior of São Paulo state, with data collection regarding bloodstream infections (BSI) occurring in the hemodialysis sector between January 2020 and July 2024. All patients aged 18 years or older were included. The type of vascular access used, isolated microorganisms, and antimicrobial susceptibility profile (BrCAST standard) were evaluated. A total of 1,637 hemodialysis sessions were recorded in 2020 and 2021, 1,895 in 2022, 1,700 in 2023, and 989 between January and July 2024, totaling 7,858 sessions. A total of 204 BSI cases were identified, corresponding to 2.6%. Regarding characteristics of BSI cases, 100 patients were men (49%) and 104 women (51%). Ages ranged from 22 to 90 years, with a mean of 62 years. The access route with the highest number of infections was Permcath (70%), followed by the double-lumen catheter (20%). Most patients (65%) had Permcath as definitive access. During the analyzed period, the most prevalent microorganisms were multisusceptible Staphylococcus aureus (14.2%) and Enterobacter cloacae resistant to cephalosporins (13.7%). A predominance of infections by multisusceptible microorganisms (75%) was observed. In the multidrug-resistant group, Staphylococcus aureus and Klebsiella pneumoniae were isolated in all study years, with higher prevalence of the former in 2024 (17.6%), while the latter peaked in 2021 (14.3%). The incidence of multidrug-resistant bacteria was 25%. Bloodstream infections are among the most important complications in patients undergoing hemodialysis. Empirical therapy for BSI should include coverage for both Staphylococcus aureus and Gram-negative bacteria, according to local epidemiology. Type of venous access and care of that access are important factors in BSI prevention. Maintaining good indices requires compliance with institutional guidelines and constant team training.
Tangerino et al. (2026) studied this question.