Predictive ability of clinical parameters of bacteremia in hemodialysed patients

Abstract

Background: No clinical events to differentiate bacteteremia from other pathologies in hemodialysis patients therefore the physicians makes diagnosis and treatment decisions based on clinical evidence an local epidemiology 
Objective: the aim of this work was to study the frequency of microorganism isolated from blood culture of hemodialysis patients with suspected bacteraemia and evaluate Sensitivity (S) and Specificity (E) of medical diagnostic orientation in this cases of suspected Materials and methods: we performed an observational and prospective study for one year in hemodialysis patient with suspected bacteremia. We evaluated blood pressure, temperature (Tº), altered conscious state (AEC), respiratory frequency (FR), chills (ESC),diarrhea (DIARR), blood culture results and microbiological identification. We work with the mean ± standar desviation for continuous variables and frequencies for categorical variables We analyzed S, E, negative predictive value (VPN), positive predictive value (VPP) Resultados: a total of 87 events with suspected bacteremia 34 (39%) were confirmed with positive blood culture the most common microorganisms were cocci Gram positive (CGP) 65%,Most relevant clinical variables were PCP ? 2 (VPN 81%), Tº ? 38 (VPN 76%) and AEC (E 98% y VPP 80%). Conclusions: CGP were the most prevalent microorganisms None of the clinical variables shows high S and E indicating low usefulness as a predictive tool of bacteremia Excepting AEC with E98% and VPP 80% but it would be necessary to evaluate this variable with a more number patient. Results justify to routine HC use like diagnostic tool.