Postgraduate medicine · 2025
Efficacy of linezolid in treating upper-extremity arteriovenous graft infection in maintenance hemodialysis patients.
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Cui Long, Yuan Hai, Gao Zhao
Аннотация
OBJECTIVE: Arteriovenous graft (AVG) infection is a severe and potentially life-threatening complication that frequently leads to graft dysfunction in patients undergoing maintenance hemodialysis (MHD). However, antimicrobial resistance are becoming increasingly common.This study investigated the efficacy of linezolid in treating graft infections and to compare the effectiveness and safety of linezolid against teicoplanin among MHD patients.
METHOD: This retrospective cohort study was conducted at a single center. A total of 53 cases of AVG infections occurring between June 2016 and June 2023 were included in this study. The AVG infections were divided into two groups: the control group (teicoplanin 200 mg/day iv) and the linezolid group (600 mg/day iv). The antimicrobial treatment period for AVG infection depended on whether the symptoms completely disappeared.Clinical data, operative records, duration of hospital stays, and costs were collected from the Hospital Information System (HIS) and analyzed between the two groups.
RESULTS: Out of the 53 patients, 30 (56.6%) were women, and their median age was 64 years. The most common clinical presentations of graft infection were purulent drainage, abscesses, pain, and swelling. Among the 53 patients, 9 (17.0%) had positive blood or wound cultures. Gram-positive cocci were the most common organisms identified. The proportion of salvaged grafts in the linezolid group was significantly higher (24 out of 28) compared to the control group (15 out of 25) (p = 0.034). The duration of hospital stays was shorter for patients in the linezolid group compared to the control group (9.6 ± 1.0 versus 16.1 ± 1.9, p = 0.012). Additionally, the average cost in the linezolid group was significantly lower than that in the control group (CNY 15,050 ± 1,611 versus 23,920 ± 4,097, p = 0.039).
CONCLUSIONS: Linezolid was found to effectively control most cases of AVG infections, resulting in shorter hospital stays and significantly reducing the clinical burden on MHD patients especially when the blood or wound cultures were negative.
METHOD: This retrospective cohort study was conducted at a single center. A total of 53 cases of AVG infections occurring between June 2016 and June 2023 were included in this study. The AVG infections were divided into two groups: the control group (teicoplanin 200 mg/day iv) and the linezolid group (600 mg/day iv). The antimicrobial treatment period for AVG infection depended on whether the symptoms completely disappeared.Clinical data, operative records, duration of hospital stays, and costs were collected from the Hospital Information System (HIS) and analyzed between the two groups.
RESULTS: Out of the 53 patients, 30 (56.6%) were women, and their median age was 64 years. The most common clinical presentations of graft infection were purulent drainage, abscesses, pain, and swelling. Among the 53 patients, 9 (17.0%) had positive blood or wound cultures. Gram-positive cocci were the most common organisms identified. The proportion of salvaged grafts in the linezolid group was significantly higher (24 out of 28) compared to the control group (15 out of 25) (p = 0.034). The duration of hospital stays was shorter for patients in the linezolid group compared to the control group (9.6 ± 1.0 versus 16.1 ± 1.9, p = 0.012). Additionally, the average cost in the linezolid group was significantly lower than that in the control group (CNY 15,050 ± 1,611 versus 23,920 ± 4,097, p = 0.039).
CONCLUSIONS: Linezolid was found to effectively control most cases of AVG infections, resulting in shorter hospital stays and significantly reducing the clinical burden on MHD patients especially when the blood or wound cultures were negative.