Risk of Vascular Access Infection Associated With Buttonhole Cannulation of Fistulas: Data From the National Healthcare Safety Network

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
Meghan LymanPriti R Patel

Abstract

Compared with conventional (rope-ladder cannulation [RLC]) methods, use of buttonhole cannulation (BHC) to access arteriovenous fistulas (AVFs) may be associated with increased risk for bloodstream infection and other vascular access-related infection. We used national surveillance data to evaluate the infection burden and risk among in-center hemodialysis patients with AVFs using BHC. Descriptive analysis of infections and related events and retrospective observational cohort study using National Healthcare Safety Network (NHSN) surveillance data. US patients receiving hemodialysis treated in outpatient dialysis centers. AVF cannulation methods, dialysis facility characteristics, and infection control practices. Access-related bloodstream infection; local access-site infection; intravenous (IV) antimicrobial start. Description of frequency and rate of infections; adjusted relative risk (aRR) for infection with BHC versus RLC estimated using Poisson regression. During 2013 to 2014, there were 2,466 access-related bloodstream infections, 3,169 local access-site infections, and 13,726 IV antimicrobial starts among patients accessed using BHC. Staphylococcus aureus was the most common pathogen, present in half (52%) of the BHC acc...Continue Reading

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Citations

Feb 12, 2021·The Journal of Vascular Access·David KingsmorePeter Thomson
May 8, 2021·Seminars in Dialysis·George KosmadakisGhania Costel
Jun 12, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Heather A MorgansUNKNOWN SCOPE Collaborative

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