Resumo Contexto Infecção é a complicação mais frequente do uso de cateter venoso central em hemodiálise. Objetivo O propósito do trabalho foi determinar a taxa de incidência de infecções de cateteres venosos centrais para hemodiálise em um centro de diálise no estado do Amazonas, bem como seus fatores preditivos, além de traçar o perfil microbiológico dessas infecções. Métodos Trata-se de um estudo observacional, com dados coletados mensalmente e de forma prospectiva, por meio de entrevista e análise de prontuários de pacientes submetidos a hemodiálise por meio de cateteres venosos centrais em um centro de diálise durante um período de 12 meses. Resultados Foram analisados 96 cateteres venosos centrais, de 48 pacientes. Do total, foram 78 cateteres venosos não tunelizados (81,3%) e 18 cateteres venosos tunelizados (18,7%). Dos cateteres acompanhados, 53,1% foram trocados por motivo de infecção, sendo realizada hemocultura de 35,2% dos pacientes que apresentaram infecção de cateter. Quanto ao perfil microbiológico, das nove hemoculturas positivas, em cinco foram isoladas bactérias gram-negativas, e em quatro foram isoladas bactérias gram-positivas. A bactéria mais frequentemente isolada foi a Staphylococcus hominis, presente em 22,2% das hemoculturas positivas. Conclusão A taxa de incidência global de infecção de cateteres venosos centrais foi de 10,1 episódios por 1.000 dias de cateter, sendo de 15,1 nos cateteres não tunelizados e de 3,3 nos cateteres tunelizados. Os fatores preditivos identificados foram o uso de cateter venoso central não tunelizado e a realização de duas sessões de diálise semanais. Quanto ao perfil microbiológico, pouco mais da metade das bactérias isoladas foram gram-negativas. Amazonas Tratase Trata se observacional prospectiva 1 meses 9 4 total 7 81,3% 813 81 3 (81,3% 18,7%. 187 18,7% . (18,7%) acompanhados 531 53 53,1 352 35 2 35,2 positivas gramnegativas, gramnegativas gram negativas, negativas gram-negativas grampositivas. grampositivas gram-positivas hominis 222 22 22,2 101 10 10, 1000 000 1.00 151 15 15, 33 3, semanais gramnegativas. negativas. 81,3 8 (81,3 18,7 (18,7% 5 53, 35, 22, 100 00 1.0 81, (81, 18, (18,7 0 1. (81 (18, (8 (18 ( (1

Abstract Background Infection is the most frequent complication of central venous catheters used for hemodialysis. Objectives The purpose of this study was to the determine the central venous catheter-related infection rate at a dialysis center in the Brazilian state of Amazonas and to identify risk factors and the microbiological profile of the infections. Methods This was an observational study with prospective data collection over a 12-month period by chart analysis and face-to-face interviews with patients undergoing hemodialysis using central venous catheters at a dialysis center. Results 96 central venous catheters were analyzed in 48 patients. 78 of these were non-tunneled central venous catheters (81.3%) and 18 were tunneled central venous catheters (18.7%), 53.1% of the catheters were exchanged because of infection and blood cultures were obtained from 35.2% of the patients who had catheter-related infections. Gram-negative bacteria were isolated from five of the nine blood cultures in which there was bacterial growth and Gram-positive bacteria were isolated from the other four. The most commonly isolated bacteria was Staphylococcus hominis, found in 22.2% of positive blood cultures. Conclusion The overall hemodialysis venous catheter infection rate was 10.1 episodes/1000 catheter days, 15.1 episodes/1000 catheters days in non-tunneled catheters and 3.3 episodes/1000 catheters days in tunneled catheters. The infection predisposing factors identified were use of non-tunneled catheters and having 2 hemodialysis sessions per week. Regarding the microbiological profile, over half of the bacteria isolated were Gram-negative. catheterrelated related infections 12month month 12 facetoface face 9 4 7 nontunneled non 81.3% 813 81 3 (81.3% 1 18.7%, 187 18.7% , (18.7%) 531 53 53.1 352 35 35.2 Gramnegative Gram negative Grampositive four hominis 222 22 22.2 101 10 10. episodes1000 episodes 1000 episodes/100 151 15 15. 33 3. week Gramnegative. negative. 81.3 8 (81.3 18.7 (18.7% 5 53. 35. 22. episodes100 100 episodes/10 81. (81. 18. (18.7 episodes10 episodes/1 (81 (18. episodes1 episodes/ (8 (18 ( (1

Abstract Tuberculosis is one of the most common infections worldwide with particularly high incidence rates in countries with unfavorable socioeconomic conditions and among persons with impaired immune systems. While most patients with this disease will present with pulmonary tuberculosis, immunocompromised individuals also commonly present with extrapulmonary manifestations. We report the case of a 28-year-old male patient with end-stage renal disease who presented with long-standing systemic symptoms and genitourinary manifestations, who was diagnosed with urogenital tuberculosis both by clinical and microbiologic criteria. Clinicians should always suspect tuberculosis in patients with chronic symptoms, especially in those with immunosuppression.