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Screening for bacteremia in sepsis and renal failure using hemofilters for renal replacement therapy

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Abstract

Background

In patients with sepsis and renal failure, extracorporeal blood flow during renal replacement therapy may lead to the deposition of bacteria on artificial membranous surfaces, which might be suitable for the detection of pathogens. We studied whether discarded dialysis hemofilters can be used for the detection of bacteremia in patients with sepsis and renal failure.

Methods

Hemofilters of 16 ICU patients with sepsis were sampled. The hemofilters were incubated with soy broth and dehisced under sterile conditions. Samples were plated on blood agar and analyzed. Patient’s characteristics were assessed.

Results

Despite the use of antibiotics in 87.5 % (14/16), a true positive detection rate of 31.3 % (5/16) for bacteremia was found by using cultures from hemofilters. The overall true positive rate of blood cultures was significantly lower (10.7 %, 8/75, p = 0.048). Bacteria detected in hemofilters were similar to those found in blood cultures or by cultures from other sources of infection in 80 % (4/5).

Conclusions

Cultures from used hemofilters of patients with sepsis and renal failure provide the opportunity to identify pathogenic microorganisms as an add-on approach. Further studies should investigate whether this method is applicable in clinical practice to enhance the sensitivity of microbiological diagnostics.

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Acknowledgments

We would like to thank Brett Montgomery, Michael L. Ekaney and Brigitte Specht for their valuable support. In part, this work was supported by the Federal Ministry of Education and Research (BMBF), Germany, FKZ: 01EO1002 to RAC and WL.

Conflict of interest

All authors report that they have no competing interests to declare related to the topic of this manuscript.

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Authors and Affiliations

  1. Clinic for Anesthesiology and Intensive Care, Jena University Hospital, Erlanger Allee 101, 07747, Jena, Germany

    G. P. Otto, M. Kropf, M. Sossdorf, P. Recknagel, W. Lösche & R. A. Claus

  2. Department for Internal Medicine III, Jena University Hospital, Erlanger Allee 101, 07747, Jena, Germany

    G. P. Otto & M. Busch

  3. Integrated Research and Treatment Center–Center for Sepsis Control and Care (CSCC), Jena University Hospital, Erlanger Allee 101, 07747, Jena, Germany

    G. P. Otto, M. Sossdorf, P. Recknagel, W. Lösche & R. A. Claus

  4. Institute of Medical Microbiology, Jena University Hospital, Erlanger Allee 101, 07747, Jena, Germany

    J. Rödel

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  1. G. P. Otto
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  2. M. Kropf
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  3. M. Sossdorf
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  4. P. Recknagel
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  5. W. Lösche
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  6. J. Rödel
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  7. R. A. Claus
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  8. M. Busch
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Corresponding author

Correspondence to G. P. Otto.

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Otto, G.P., Kropf, M., Sossdorf, M. et al. Screening for bacteremia in sepsis and renal failure using hemofilters for renal replacement therapy. Infection 41, 387–390 (2013). https://doi.org/10.1007/s15010-012-0372-0

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  • DOI: https://doi.org/10.1007/s15010-012-0372-0

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