Black and Hispanic Patients on Dialysis Have Higher Rates of Staph Bloodstream Infections CDC Online Newsroom

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In adults receiving dialysis treatment for end-stage kidney disease, a Staphylococcus aureus (staph) bloodstream infections compared to adults not on dialysis during 2017-2020, according to a new vital signs Report released today by the Centers for Disease Control and Prevention (CDC).

More than half of people receiving dialysis in the US are from a racial or ethnic minority group – nearly 1 in 3 people receiving dialysis is black and 1 in 5 is Hispanic. The CDC data found that patients on dialysis in these groups have higher rates of staph bloodstream infections than white patients on dialysis.

Dialysis treatment, although essential and life-saving, comes with risks. Healthcare providers use a needle or catheter to connect a patient to a dialysis machine, and germs such as staph can enter the patient’s bloodstream. Staph bloodstream infections can be serious and even fatal. Some infections are resistant to some of the most common antibiotics used to treat them, making the drugs ineffective.

CDC data confirmed that one of the key ways healthcare providers reduce the risk of infection is to replace central venous catheters to connect patients’ blood circulation to dialysis machines for treatments with lower risks such as fistulas and grafts. using the options.

Hispanic patients on dialysis had a 40% higher risk of staph bloodstream infection than white patients on dialysis between 2017 and 2020. Other challenges for many patients on dialysis include:

  • Lack of access to preventive care for conditions such as diabetes and high blood pressure, which increase the risk of developing end-stage kidney disease.
  • Lack of patient education about treatment options for end-stage renal disease.
  • Extended use of a central venous catheter (also called a vascular access type) to connect the patient’s circulation to a dialysis machine for treatment. Of all the vascular access types, catheters have the highest risk of infection.
  • Socioeconomic factors, including poverty, household crowding, and low education levels.

“Preventing staph bloodstream infections begins with detecting chronic kidney disease in the early stages to prevent or delay the need for dialysis,” said Debra Houry, MD, MPH, CDC’s chief medical officer. Providing education on high blood pressure, as well as treatment options to slow the progression of chronic kidney disease, among all patients and especially those at greatest risk.

CDC researchers used data from the 2020 National Healthcare Safety Network (NHSN) and the 2017-2020 Emerging Infections Program (EIP) to describe bloodstream infections among dialysis patients. To examine associations with race, ethnicity, and social determinants of health, these data were linked to population-based data sources (CDC/ATSDR’s Social Vulnerability Index, United States Renal Data System, US Census).

key findings:

  • In 2020, 4,840 dialysis facilities reported 14,822 bloodstream infections to the NHSN; 34% were due to staff.
  • In both the NHSN and EIP systems, vascular access via a central venous catheter was strongly associated with staph bloodstream infection.
  • Of the seven EIP sites in 2017-2020:
    • The staph bloodstream infection rate was 100 times higher in dialysis patients than in adults not on dialysis.
    • Among patients on dialysis, black and Hispanic patients had the highest staph bloodstream infection rates.
    • Adjusting for living status, age, gender, and vascular access type, the risk of staph bloodstream infection was highest among Hispanic patients and patients 18–49 years old.
    • Staph bloodstream infections were more common in people in areas of high poverty, household crowding, and low education.

“Dialysis-associated bloodstream infections are preventable—not inevitable,” said Shannon Novosad, MD, MPH, dialysis safety team lead in the CDC’s Division of Healthcare Quality Promotion. “Our data show that the use of a central venous catheter as a vascular access type was associated with a sixfold higher risk for staph bloodstream infection than the lowest-risk access, fistula. Prevention efforts that equally lower risk Those promoting vascular access types and consistent use of infection prevention and control best practices can save lives.

The good news is that bloodstream infections among patients on dialysis have decreased since 2014 with the widespread use of proven practices to prevent and control infections. Preventing infections in patients receiving dialysis requires a comprehensive and equitable approach to kidney disease prevention and care for people of all racial, ethnic and socioeconomic groups. Healthcare providers and public health professionals should continue to:

  • Encourage practices shown to prevent and slow the progression of chronic kidney disease.
  • Advise patients on possible treatment options before end-stage renal disease develops.
  • Coordinated efforts among patients, nephrologists, vascular access surgeons, radiologists, nurses, nurse practitioners, and social workers to reduce the use of central venous catheters for dialysis treatment.
  • Increase the use of low-risk vascular access types, such as fistulas and grafts, for people starting and currently on dialysis.
  • Use proven practices to prevent and control infection in all US dialysis facilities.
  • Lower barriers for patients seeking medical care by offering transportation assistance, insurance coverage expertise, social work services and education resources in multiple languages.

For more information about this report, visit

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