Hispanic and black patients on dialysis have higher rates of staph infections: CDC:NPR
Data shows that black and Hispanic patients on dialysis in the United States have a higher risk of developing staph bloodstream infections than their white counterparts, federal health officials say, adding that reducing inequities can save lives .
A report released Monday by the Centers for Disease Control and Prevention highlights the risks and disparities associated with dialysis for end-stage kidney disease, in which a machine does the work of these organs by removing waste and excess blood fluid.
“More than half of people in the United States on dialysis belong to a racial or ethnic minority group — approximately 1 in 3 people on dialysis are black and 1 in 5 are Hispanic,” the CDC said in a statement. “CDC data revealed that dialysis patients in these groups had higher rates of staph bloodstream infections than white patients on dialysis.”
Dialysis treatment is necessary for people with failing kidneys — often as a result of high blood pressure, diabetes, lupus or other conditions — but comes with risks, according to the CDC.
Because patients are connected to machines with needles or catheters, Staphylococcus and other bacteria can enter their bloodstream. Dialysis facilities reported more than 14,000 bloodstream infections to a national tracking system in 2020, 34% of which were due to staph. Some 560,000 Americans with end-stage kidney disease received dialysis that year.
Some staph infections are resistant to the antibiotics commonly used to treat them and can be fatal.
Between 2017 and 2020, the CDC found that adults on dialysis for end-stage kidney disease were 100 times more likely to have staphylococcal bacteremia than adults who did not receive the treatment. Hispanic patients had a 40% higher risk of these infections than white patients during this period.
After adjusting for age, gender, and other factors, the study concludes that Hispanic patients and those ages 18 to 49 are most at risk, as are people living in poorer, crowded areas. and poorly educated.
The CDC described other common challenges for many dialysis patients, including lack of access to preventive care for conditions such as diabetes and high blood pressure and lack of patient education about treatment options. end-stage renal failure.
The unadjusted rate of staph bloodstream infections in black patients was 23% higher than in white patients, but when the CDC adjusted for other factors, the rate was not statistically significant, CNBC reports.
“It’s always important to point out these high rates because staph bloodstream infections occur at a higher rate in black patients on dialysis, but there are other factors that contribute to this high rate besides race alone” , CDC spokeswoman Martha Sharan said.
There is some encouraging news, however: bacteremias in dialysis patients have declined since 2014, and there are steps patients and healthcare providers can take to try to avoid them.
“Dialysis-associated blood infections are preventable — not inevitable,” said Dr. Shannon Novosad, leader of the dialysis safety team at the CDC’s Division of Health Care Quality Promotion.
What Public Health and Health Care Professionals Can Do
The CDC says the best way to prevent staph bloodstream infections is to detect chronic kidney disease early enough that patients need dialysis.
“Health care providers can promote preventative practices, including methods for managing diabetes and high blood pressure, as well as provide education about treatment options among all patients and especially those most at risk. , to slow the progression of chronic kidney disease,” says the CDC’s medical chief. Officer Debra Houry.
The report highlights the importance of reducing barriers to health care by providing transportation assistance, insurance coverage expertise, social work services and educational resources in multiple languages.
Although chronic kidney disease is generally irreversible, certain nutritional, lifestyle and medical interventions can help slow its progression. These include limiting sodium, quitting smoking and improving blood pressure control.
When dialysis is needed, the CDC says providers should prioritize methods that pose a lower risk of infection, including using proven infection prevention and control practices. It could also mean using fistulas or grafts instead of high-risk catheters.
“Education and implementation of established best practices to prevent bloodstream infections are essential to protect all of [dialysis] community of patients”, concludes the study, “including those most at risk”.