In Brazil, an increasing annual number of patients require renal replacement therapy (RRT), and about 30% use vascular access for dialysis; device-related infections are the complications associated with the greatest morbidity and mortality. To analyze the epidemiological and microbiological profiles of healthcare-associated infections (HAIs) in outpatient hemodialysis (HD). Historical cohort of acute dialysis patients who underwent HD in a tertiary hospital between January 1, 2023 and May 31, 2025. HAI data were extracted from the anonymized database of the Hospital Infection Control Service. HAIs were classified according to Agência Nacional de Vigilância Sanitária criteria (ANVISA 2025). Sixty patients were included. Median age was 52 years; 65% were male. Regarding comorbidities, 41.6% had hypertension, 3.3% had diabetes, and 35% had both hypertension and diabetes. During the study period, 11 patients (18.3%) required hospitalization due to HD-associated HAIs; of these, 8 had temporary catheters and 3 had permanent catheters. Infection rates related to temporary access were higher than those for permanent access and arteriovenous fistulas (AVF) (76.6%, 21.6%, and 1.6%, respectively). HAIs were classified as vascular access infection (51.6%) and access-associated bacteremia (48.4%). Among bacteremia pathogens, Staphylococcus aureus stood out (55.17%), with 12 (75%) oxacillin-susceptible and 4 (25%) oxacillin-resistant, and Pseudomonas aeruginosa (17.24%), with 4 (80%) carbapenem-susceptible and 1 (20%) carbapenem-resistant. Hospitalizations and HAIs were more frequent in patients with temporary catheters. The most frequently isolated microorganisms in bacteremias were oxacillin/methicillin-susceptible S. aureus. These indicators have contributed to developing strategies to implement permanent catheters and AVFs to deliver RRT more safely and with lower HAI risk.
Coutinho et al. (Sun,) studied this question.