Infection Prevention and Control Practices Among United States Hemodialysis Facilities

This is the authors' abstract. We don't add key points for this paper.

Introduction: From 2014 through 2019, bloodstream infection (BSI) rates among US hemodialysis patients decreased by 40%. Several national efforts to address the burden of BSIs among hemodialysis patients were introduced spanning 2015 through 2019. We aimed to compare facility-reported infection prevention and control (IPC) practices in 2015 and 2021, to identify changes in practices nationally. Methods: selected as possibly suggesting a meaningful change. Results: In 2021, 7400 facilities completed the survey, comprising 503,530 dialysis patients. In 2021 compared with 2015, >5% point change was observed for several recommended catheter care practices such as exit site care (use of chlorhexidine with alcohol for skin antisepsis [90.8% uptake, +5.9% points] and antimicrobial ointment or chlorhexidine-impregnated dressing [29.0%, +6.4% points]), and catheter hub care (alcohol for hub antisepsis [84.3%, +9.9% points]). In 2021, 49.3% of facilities used chlorhexidine-impregnated catheter caps. Discussion: Increased uptake of recommended IPC practices, and introduction of chlorhexidine-impregnated catheter caps may have contributed to decreased BSI rates among hemodialysis patients. Continued efforts are needed to increase adoption of Centers for Disease Control and Prevention (CDC)-recommended catheter exit site care practices and ensure maintenance of IPC practices with high uptake.