Kidney Health Australia - Caring for Australasians with Renal Impairment guideline recommendations for infection control for haemodialysis units

Meg Jardine, Robert J. Commons, Janak R. de Zoysa, Muh G. Wong, Nicole Gilroy, Julianne Green, Belinda Henderson, Rhonda L. Stuart, David J. Tunnicliffe, Carolyn van Eps, Eugene Athan

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Aim: There is no national consensus on infection control in haemodialysis units in Australia and New Zealand. The primary aim of this guideline was to provide recommendations on screening for blood-borne viruses and multi-resistant organisms for dialysis units based on the available evidence.

Methods: The Kidney Health Australia Caring for Australasians with Renal Impairment guidelines, overall approach to guideline development follows the GRADE framework. A facilitated workshop was conducted to ensure that patient and caregiver concerns were considered. The evidence from relevant medical databases on the impact of screening on detection and transmission rates, hospitalization, mortality and psychosocial care, was reviewed and critically appraised. The guideline group made recommendations from the evidence available.

Results:
The main guideline recommendations are:

Dialysis units adopt a comprehensive approach that encompasses standard infection control precautions.
Conduct routine surveillance for key blood-borne viruses and methicillin-resistant Staphylococcus aureus.
Conduct routine surveillance of individual levels of protection against hepatitis B for patients on haemodialysis. Use dedicated dialysis machines for HBV-infected patients.

The evidence in totality was not found to support routine surveillance of vancomycin-resistant Enterococci. Enhanced surveillance in light of the local risk of transmittable infectious agents should be considered by dialysis units. Very few studies have reported on the potential adverse effects of screening and associated practices.

Conclusions: Future research should focus on the potential benefits and adverse effects of screening and associated practices on clinical outcomes including infections prevented and health service delivery, and psychosocial domains for patients. Given the results of trials in the critical setting, the effectiveness of methicillin-resistant Staphylococcus aureus decolonization in people receiving dialysis therapy warrants further research.
Original languageEnglish
Pages (from-to)951-957
Number of pages7
JournalNephrology
Volume24
Issue number9
Early online date16 Oct 2018
DOIs
Publication statusPublished - Sep 2019

Fingerprint

Infection Control
Renal Dialysis
Dialysis
Guidelines
Kidney
Health
Methicillin-Resistant Staphylococcus aureus
Viruses
Hepatitis B
New Zealand
Caregivers
Health Services
Consensus
Hospitalization
Databases
Education
Mortality
Infection
Research
Therapeutics

Cite this

Jardine, Meg ; Commons, Robert J. ; de Zoysa, Janak R. ; Wong, Muh G. ; Gilroy, Nicole ; Green, Julianne ; Henderson, Belinda ; Stuart, Rhonda L. ; Tunnicliffe, David J. ; van Eps, Carolyn ; Athan, Eugene. / Kidney Health Australia - Caring for Australasians with Renal Impairment guideline recommendations for infection control for haemodialysis units. In: Nephrology. 2019 ; Vol. 24, No. 9. pp. 951-957.
@article{e87a7d03fef14a2698ea23127be5082a,
title = "Kidney Health Australia - Caring for Australasians with Renal Impairment guideline recommendations for infection control for haemodialysis units",
abstract = "Aim: There is no national consensus on infection control in haemodialysis units in Australia and New Zealand. The primary aim of this guideline was to provide recommendations on screening for blood-borne viruses and multi-resistant organisms for dialysis units based on the available evidence. Methods: The Kidney Health Australia Caring for Australasians with Renal Impairment guidelines, overall approach to guideline development follows the GRADE framework. A facilitated workshop was conducted to ensure that patient and caregiver concerns were considered. The evidence from relevant medical databases on the impact of screening on detection and transmission rates, hospitalization, mortality and psychosocial care, was reviewed and critically appraised. The guideline group made recommendations from the evidence available. Results: The main guideline recommendations are: Dialysis units adopt a comprehensive approach that encompasses standard infection control precautions. Conduct routine surveillance for key blood-borne viruses and methicillin-resistant Staphylococcus aureus. Conduct routine surveillance of individual levels of protection against hepatitis B for patients on haemodialysis. Use dedicated dialysis machines for HBV-infected patients. The evidence in totality was not found to support routine surveillance of vancomycin-resistant Enterococci. Enhanced surveillance in light of the local risk of transmittable infectious agents should be considered by dialysis units. Very few studies have reported on the potential adverse effects of screening and associated practices. Conclusions: Future research should focus on the potential benefits and adverse effects of screening and associated practices on clinical outcomes including infections prevented and health service delivery, and psychosocial domains for patients. Given the results of trials in the critical setting, the effectiveness of methicillin-resistant Staphylococcus aureus decolonization in people receiving dialysis therapy warrants further research.",
keywords = "blood borne virus, haemodialysis, infectious disease, multidrug resistant organism, practice guideline",
author = "Meg Jardine and Commons, {Robert J.} and {de Zoysa}, {Janak R.} and Wong, {Muh G.} and Nicole Gilroy and Julianne Green and Belinda Henderson and Stuart, {Rhonda L.} and Tunnicliffe, {David J.} and {van Eps}, Carolyn and Eugene Athan",
year = "2019",
month = "9",
doi = "10.1111/nep.13511",
language = "English",
volume = "24",
pages = "951--957",
journal = "Nephrology",
issn = "1320-5358",
publisher = "Wiley-Blackwell",
number = "9",

}

Jardine, M, Commons, RJ, de Zoysa, JR, Wong, MG, Gilroy, N, Green, J, Henderson, B, Stuart, RL, Tunnicliffe, DJ, van Eps, C & Athan, E 2019, 'Kidney Health Australia - Caring for Australasians with Renal Impairment guideline recommendations for infection control for haemodialysis units', Nephrology, vol. 24, no. 9, pp. 951-957. https://doi.org/10.1111/nep.13511

Kidney Health Australia - Caring for Australasians with Renal Impairment guideline recommendations for infection control for haemodialysis units. / Jardine, Meg; Commons, Robert J.; de Zoysa, Janak R.; Wong, Muh G.; Gilroy, Nicole; Green, Julianne; Henderson, Belinda; Stuart, Rhonda L.; Tunnicliffe, David J.; van Eps, Carolyn; Athan, Eugene.

In: Nephrology, Vol. 24, No. 9, 09.2019, p. 951-957.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Kidney Health Australia - Caring for Australasians with Renal Impairment guideline recommendations for infection control for haemodialysis units

AU - Jardine, Meg

AU - Commons, Robert J.

AU - de Zoysa, Janak R.

AU - Wong, Muh G.

AU - Gilroy, Nicole

AU - Green, Julianne

AU - Henderson, Belinda

AU - Stuart, Rhonda L.

AU - Tunnicliffe, David J.

AU - van Eps, Carolyn

AU - Athan, Eugene

PY - 2019/9

Y1 - 2019/9

N2 - Aim: There is no national consensus on infection control in haemodialysis units in Australia and New Zealand. The primary aim of this guideline was to provide recommendations on screening for blood-borne viruses and multi-resistant organisms for dialysis units based on the available evidence. Methods: The Kidney Health Australia Caring for Australasians with Renal Impairment guidelines, overall approach to guideline development follows the GRADE framework. A facilitated workshop was conducted to ensure that patient and caregiver concerns were considered. The evidence from relevant medical databases on the impact of screening on detection and transmission rates, hospitalization, mortality and psychosocial care, was reviewed and critically appraised. The guideline group made recommendations from the evidence available. Results: The main guideline recommendations are: Dialysis units adopt a comprehensive approach that encompasses standard infection control precautions. Conduct routine surveillance for key blood-borne viruses and methicillin-resistant Staphylococcus aureus. Conduct routine surveillance of individual levels of protection against hepatitis B for patients on haemodialysis. Use dedicated dialysis machines for HBV-infected patients. The evidence in totality was not found to support routine surveillance of vancomycin-resistant Enterococci. Enhanced surveillance in light of the local risk of transmittable infectious agents should be considered by dialysis units. Very few studies have reported on the potential adverse effects of screening and associated practices. Conclusions: Future research should focus on the potential benefits and adverse effects of screening and associated practices on clinical outcomes including infections prevented and health service delivery, and psychosocial domains for patients. Given the results of trials in the critical setting, the effectiveness of methicillin-resistant Staphylococcus aureus decolonization in people receiving dialysis therapy warrants further research.

AB - Aim: There is no national consensus on infection control in haemodialysis units in Australia and New Zealand. The primary aim of this guideline was to provide recommendations on screening for blood-borne viruses and multi-resistant organisms for dialysis units based on the available evidence. Methods: The Kidney Health Australia Caring for Australasians with Renal Impairment guidelines, overall approach to guideline development follows the GRADE framework. A facilitated workshop was conducted to ensure that patient and caregiver concerns were considered. The evidence from relevant medical databases on the impact of screening on detection and transmission rates, hospitalization, mortality and psychosocial care, was reviewed and critically appraised. The guideline group made recommendations from the evidence available. Results: The main guideline recommendations are: Dialysis units adopt a comprehensive approach that encompasses standard infection control precautions. Conduct routine surveillance for key blood-borne viruses and methicillin-resistant Staphylococcus aureus. Conduct routine surveillance of individual levels of protection against hepatitis B for patients on haemodialysis. Use dedicated dialysis machines for HBV-infected patients. The evidence in totality was not found to support routine surveillance of vancomycin-resistant Enterococci. Enhanced surveillance in light of the local risk of transmittable infectious agents should be considered by dialysis units. Very few studies have reported on the potential adverse effects of screening and associated practices. Conclusions: Future research should focus on the potential benefits and adverse effects of screening and associated practices on clinical outcomes including infections prevented and health service delivery, and psychosocial domains for patients. Given the results of trials in the critical setting, the effectiveness of methicillin-resistant Staphylococcus aureus decolonization in people receiving dialysis therapy warrants further research.

KW - blood borne virus

KW - haemodialysis

KW - infectious disease

KW - multidrug resistant organism

KW - practice guideline

UR - http://www.scopus.com/inward/record.url?scp=85065168628&partnerID=8YFLogxK

U2 - 10.1111/nep.13511

DO - 10.1111/nep.13511

M3 - Article

VL - 24

SP - 951

EP - 957

JO - Nephrology

JF - Nephrology

SN - 1320-5358

IS - 9

ER -