Abstract
Hemodialysis requires repeated, reliable access to the systemic
circulation; therefore, a well-functioning vascular access (VA)
procedure is crucial for stable hemodialysis. VA infections (VAIs)
constitute the most challenging complication and cause considerable
morbidity, loss of access,
and
even death. In this study, we investigated the molecular profiles of
different bacterial isolates retrieved from various types of VA grafts.
We collected clinical isolates from hemodialysis patients with VAIs in
our institution for the period between 2013 and 2018. We identified the
bacterial isolates using standard biochemical procedures; we used a
polymerase chain reaction for coagulase-negative staphylococcus (CoNS)
and Burkholderia cepacia complex (BCC) species identification.
The antibiotic resistance and molecular profile were analyzed using the
disk diffusion method and multilocus sequence typing, respectively. We
studied 150 isolates retrieved from patients with VAI and observed thatStaphylococcus aureus was the predominant bacterial species,
followed by S. argenteus , BCC, and CoNS. According to multilocus
sequence typing data, we identified a wide variety of sequence types
(STs) in S. aureus isolates, with ST59, ST45, and ST239 being the
predominant types. Burkholderia cepacia with two new ST types,
namely ST1723 and ST1724, accounted for most of the BCC infections,
along with ST102 B. contaminans , which were mainly isolated from
infected tunneled-cuffed catheters. In summary,
the increased incidence ofS. argenteus and BCC infections provides insights into their
potential clinical effects in VAIs. The various STs identified in
different bacterial species indicate the high genetic diversity of
bacterial species isolated from VAIs in our institution.