Infection of Double Lumen Catheter as Hemodialysis Access

Abstract
Background
Intravascular catheters required for the care of many hospitalized patients can give rise to
bloodstream infection, a complication of care that has occurred most frequently in hospital.
Staphylococcus aureus is pathogen in human. Catheter-related bloodstream infections, exit-site
infections, and tunnel infections are common complications related to hemodialysis central
venous catheter use. The most common causative pathogens are gram-positive bacteria,
with Staphylococcus aureus.
43 year old, women, came with complaints of fever since 1 week after dialysis, the patient also
complained of chills and pain in the right thigh. The patient says that the fever can go down if
you take a fever reducer. But after that a few hours later the patient returned complaining of
fever. The patient also complained of pain at DLC access since 1 week. Swelling is not felt, there
is no pus and blood at the DLC access site. The patient has chronic kidney disease with dialysis
routine. Dialysis is done three times a week. The laboratory examination did not find an increase,
where the WBC was 8990 /UL, there was a decrease in Hb 8.3 g/dL, thrombocytes 107000/uL,
urea 86 mg/dL, creatinine 7.2. On physical examination, there was no swelling and pus in
intravenous access. The patient was given the antibiotic ceftriaxone 2g?24 hours. The patient
then carried out the action of transferring DLC access to the left femoral vein because the patient
complained of pain at the previous location and central blood and peripheral blood were taken
and the catheter tip was taken for culture. Catheter tips culture results and gram staining were
obtained from gram staining of gram-positive cocci 2+/LPB, and gram-negative bacilli 1+/LPB.
Blood culture showed staphylococcus aureus central. Blood culture showed peripheral
staphylococcus aureus.
Conclusion
Diagnosis and treatment should be given immediately according to clinical manifestations and
investigations. The management of antibiotics must be in accordance with the nature and type of
the bacteria.