Search Results (203)

Background: Evidence on HAIs in Africa is fairly common. Objectives: The main objective was to identify the surveillance tools used for healthcare–associated infections (HAIs) in countries in the WHO African Region. Secondary objectives focused on the organization of surveillance, the pathogens involved, and the frequency of multidrug–resistant species. Inclusion and exclusion criteria: Observational or interventional studies on healthcare–associated infections in humans, published between January 2011 and December 2024, in French or English, were included. However, the following publications were not included: animal studies, healthcare–associated infections not related to healthcare, literature reviews, studies outside the period or geographical area, and studies in languages other than French or English. Sources of information and search date: The databases consulted were PubMed, Web of Science, EMBASE, Cochrane, African Index Medicus, Google Scholar, and AJOL. The search was conducted between January and March 2025. Risk of bias assessment: The risk of bias was assessed using a specific grid (eleven criteria), scored from one (low) to three (high). The studies were classified into three levels of methodological quality. The results of the bias assessment showed that the publications were excellent (strong and moderate) with a cumulative rate of 99.9%. Methods of synthesizing results: Data were extracted using a standardized grid and synthesized narratively. No meta–analysis was performed. Number of studies and characteristics: 95 studies were included, mostly cross–sectional studies (82.1%), cohorts (10.4%), and a few case reports. Most were from West Africa (60.0%), particularly Nigeria (16.8%) and South Africa (14.7%). Main results: • Most common pathogens: Staphylococcus aureus (53.7%), Escherichia coli (43.2%), Klebsiella pneumoniae (32.6%). • Resistance profile: ESBL (27.4%), MRSA (21.1%), multidrug resistance (13.7%). • Sources of HAIs: mainly exogenous (83.2%). • Laboratory methods: phenotypic (70.5%), genotypic or genomic rare (3.1%). • Scope of studies: local (96.8%), national (3.2%). Limitations of evidence: Risk of bias due to underreporting of HAIs, methodological heterogeneity, predominance of cross–sectional studies, low use of molecular methods, lack of modeling, and uneven geographical coverage. Overall interpretation and implications: surveillance of HAIs in Africa remains fragmented and poorly standardized. There is a need to strengthen national systems, integrate molecular methods, train professionals, and promote interventional research. The WHO GLASS program can serve as a framework for harmonizing surveillance. Full article

Background: Surgical site infections (SSIs) are common postoperative complications. Data on SSIs following breast surgery in Saudi Arabia are limited because these procedures are not included in the national SSI surveillance system. This study determined the SSI incidence rate, identified associated risk factors, and described the microbiological profiles of patients undergoing breast surgery at two tertiary hospitals in Saudi Arabia. Methods: This bicentric retrospective case–control study analyzed 1841 breast surgeries performed at two tertiary hospitals between July 2021 and July 2024. Demographic, surgical, and microbiological data were extracted from electronic medical records. SSIs were defined according to National Healthcare Safety Network criteria. Descriptive statistics summarized patient and surgical characteristics and SSI rates. A matched case–control analysis (1:4 ratio based on age and hospital site) included 172 patients. Multivariable logistic regression was used to identify predictors of SSI. Results: The cumulative SSI incidence was 2.4%, and most infections occurred within 30 days of surgery (69%). Gram-negative organisms were predominant in microbiologically positive cases (53.6%), mainly Klebsiella pneumoniae and Pseudomonas aeruginosa, whereas Staphylococcus aureus (including MRSA) accounted for 25%. Immunocompromised status (OR 3.32, 95% CI 1.35–8.14) and surgical drain use (OR 4.07, 95% CI 1.68–9.87) were independently associated with SSI. Conclusions: The incidence of SSIs after breast surgery in Saudi Arabia was relatively low. The predominance of Gram-negative pathogens and the identification of immunocompromised status and surgical drain use as major risk factors highlight opportunities for targeted infection prevention strategies. Further studies should validate these findings in larger and more diverse populations and healthcare settings. Full article

Antimicrobial resistance (AMR) is a global health threat, increasing morbidity, mortality, and healthcare costs. Multi-drug resistant ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter cloacae) cause most hospital-acquired infections. Local data on their resistance profiles remain limited in low-income settings. This study assessed the prevalence and resistance patterns of ESKAPE pathogens isolated from clinical specimens at Rwanda Military Referral and Teaching Hospital. A descriptive cross-sectional study was conducted from June 2022 to January 2023. ESKAPE isolates were identified and tested for antimicrobial susceptibility using the BD Phoenix M50 System. Data on sample type, ward, and demographics were analyzed. Of 744 bacterial findings, 207 (30%) were ESKAPE isolates. After excluding duplicates and non-recovered isolates, 156 were identified as ESKAPE. K. pneumoniae was most common (41%), followed by S. aureus (27%), A. baumannii (13%), P. aeruginosa (11%), and E. cloacae (8%); no E. faecium was detected. Among Gram-negatives, 63% were resistant to third-generation cephalosporins and 32% to carbapenems, with A. baumannii showing highest resistance (85% and 75%). Methicillin-Resistance in Staphylococcus aureus (MRSA) was 7%. This first hospital-based study in Rwanda shows high cephalosporin and carbapenem resistance, highlighting the need to strengthen diagnostics and stewardship. Full article

Celtis africana, a rare plant native to southwestern Saudi Arabia, was explored for the first time as a source for the green synthesis of silver nanoparticles (AgNPs). Catechol-bearing phenolic amides in the aqueous leaf extract acted as both reducing and capping agents, enabling eco-friendly AgNP fabrication. The synthesized AgNPs were characterized using SEM, TEM, XRD, UV-Vis, and FTIR, revealing predominantly spherical nanoparticles with an average size of 9.28 ± 0.11 nm, a face-centered cubic crystalline structure, and a pronounced surface plasmon resonance at 424 nm. HPLC analysis confirmed the presence of caffeoyltryamine in the extract, while UV-Vis and FTIR indicated its attachment to the AgNP surface. The AgNPs exhibited broad-spectrum antimicrobial activity against Gram-positive bacteria (S. aureus, MRSA and E. faecalis) and Gram-negative bacteria (E. coli, K. pneumoniae, S. typhimurium, and P. aeruginosa), as well as pathogenic fungi such as C. albicans, C. glabrata, C. parapsilosis, and C. krusei with performance comparable to or exceeding that of AgNPs from Artemisia vulgaris, Moringa oleifera, and Nigella sativa. The MIC and MBC values for S. aureus, MRSA, E. coli, and S. typhimurium were consistently 6.25 µg/mL and 25 µg/mL, respectively, reflecting strong inhibitory and bactericidal effects at low concentrations. MTT assays demonstrated selective cytotoxicity, showing higher viability in normal human skin fibroblasts (HSF) than in MCF-7 breast cancer cells. The AgNPs also displayed strong antioxidant activity (IC₅₀ = 5.41 µg/mL, DPPH assay) and efficient catalytic reduction of 4-nitrophenol (4-NP) and methylene blue (MB), with rate constants of 0.0165 s⁻¹ and 0.0047 s⁻¹, respectively, exceeding most reported values. These findings identify Celtis africana as a promising source for eco-friendly AgNPs with strong antimicrobial, antioxidant, and catalytic properties for broad biological and environmental applications. Full article

Milk contains wide microbial diversity, composed mainly of lactic acid bacteria (LAB), which are used as probiotics for both humans and livestock. We isolated, characterized, and evaluated LAB from indigenous Saudi Arabian camel milk to assess its probiotic potential, including antagonistic activity (against Methicillin-Resistant Staphylococcus aureus (MRSA) and Klebsiella pneumoniae), survivability in simulated gastric juice, tolerance to bile salts, cell surface hydrophobicity, auto- and co-aggregation, and antibiotic susceptibility tests. The two most promising LAB strains showed probiotic potential and were identified as Leuconostoc mesenteroides based on 16S rRNA gene sequences. These strains inhibited all pathogens tested to varying degrees and were resistant to kanamycin and vancomycin. None of the LAB cultures demonstrated hemolytic or gelatinase activity. Overall, the current data suggests that camel milk has substantial potential for introducing probiotics/LAB strains into the human food chain, making camel milk a potentially sustainable food. Full article

Background: The escalating burden of antimicrobial resistance (AMR) poses a critical threat to public health in Pakistan, with rates of high antibiotic consumption and limited standardized surveillance on AMR rates. Our study aimed to carry out a multicentric surveillance of AMR to generate regional antibiograms for Northern Punjab, Pakistan, to guide empirical antimicrobial therapy and stewardship efforts. Methods: A laboratory-based, retrospective cross-sectional study was conducted over a six-month period across three tertiary care hospitals. Socio-demographic, clinical, and microbiological data (including specimen type and antibiotic prescription rates) were collected from N = 485 patients with confirmed bacterial infections. Antimicrobial susceptibility testing was performed based on Clinical Laboratory Standards Institute (CLSI) recommendations. Statistical analyses were carried out using SPSS v.22.0. Results: In our study setting, Gram-positive bacteria were common causes (60.0%) of infections, with Staphylococcus aureus (12.2%) and Streptococcus pneumoniae (10.3%) being the most relevant. Among Gram-negative bacteria (40.0%), Escherichia coli (14.0%) and Pseudomonas aeruginosa (5.8%) were shown to be important pathogens. Overall, 25.0% of S. aureus isolates were methicillin-resistant (MRSA), while ~30% of E. coli showed resistance to third-generation cephalosporins (3GCs). Enterobacterales species had highly variable susceptibility rates (40–70%) for fluoroquinolones. Meropenem and vancomycin/linezolid retained high efficacy (>90%) against most Gram-negative and Gram-positive isolates, respectively. In all healthcare settings studied, ceftriaxone was the most frequently prescribed antibiotic. Conclusions: High levels of resistance against first-line antibiotics were noted in our setting of Northern Punjab, Pakistan, underscoring the critical need for robust antimicrobial stewardship programs, tailored to local institutional contexts, capabilities, and needs. The regional antibiogram developed based on our data may provide vital evidence for informing local empirical treatment guidelines, which need to be continuously updated. Full article

Recently published halogenated anilides of chlorinated and trifluorinated cinnamic acids, such as (2E)-N-[3,5-bis(trifluoromethyl)phenyl]-3-(3,4-dichlorophenyl)prop-2-enamide, (2E)-N-(3,5-dichlorophenyl)-3-[3-(trifluoromethyl)phenyl]prop-2-enamide, or (2E)-N-[3,5-bis(trifluoromethyl)phenyl]-3-[4-(trifluoromethyl)phenyl]prop-2-enamide, showed excellent antibacterial activities in vitro against Gram-positive bacteria, especially against reference and quality control strains Staphylococcus aureus ATCC 29213 and Enterococcus faecalis ATCC 29212, as well as against representatives of multidrug-resistant bacteria, clinical isolates of methicillin-resistant S. aureus (MRSA), and vancomycin-resistant E. faecalis (VRE) with minimum inhibitory concentrations (MICs) against staphylococci < 0.2 µg/mL and against enterococci < 4 µg/mL. It should be noted that all these compounds are rather lipophilic (software predicted log P values close to 5) and carry electron-withdrawing substituents that allow them to be classified as so-called Michael acceptors. All these facts inspired further investigation of the spectrum of effectiveness against other bacteria, and the most effective agents with various substitutions in both the anilide part and on the phenyl ring of the parent cinnamic acid were chosen and tested against selected pathogenic Gram-negative bacteria, such as reference and quality control strains Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 27859, and a clinical isolate of Klebsiella pneumoniae 797. Unfortunately, it was found that none of the selected halogenated anilide derivatives with such high potency against Gram-positive bacteria demonstrated better efficacy against the tested Gram-negative bacteria than a MIC of 256 µg/mL. Full article

Background: Gynecological infections, including bacterial vaginosis, vulvovaginal candidiasis, and recurrent urinary tract infections, represent a major clinical burden and are often complicated by biofilm formation and antimicrobial resistance. Novel non-antibiotic strategies are urgently needed. We previously demonstrated the antimicrobial activity of silver-bound titanium dioxide (TiAB) against multidrug-resistant bacteria isolated from dermatological infections. Objectives: We evaluated whether TiAB, at concentrations used in marketed medical devices, exerts antibacterial and antifungal effects against clinically relevant vaginal isolates by determining Minimum Inhibitory Concentration/ Minimum Bactericidal and Fungicidal Concentration (MIC, MBC/MFC), and time–kill kinetics. Methods: A total of 73 clinical isolates were collected from vaginal swabs, including Staphylococcus aureus (MSSA, MRSA), Escherichia coli (ESBL+ and non-ESBL), Klebsiella pneumoniae, Enterococcus spp., Streptococcus agalactiae, and Candida albicans. Minimum inhibitory concentrations (MICs) and minimum bactericidal/fungicidal concentrations (MBCs/MFCs) were determined by broth microdilution, and bactericidal activity was confirmed by time-kill assays. Results: TiAB exhibited potent activity against Gram-negative bacteria, with median MIC values of 1–2% (w/v) for E. coli and K. pneumoniae. Gram-positive isolates, including S. agalactiae and Enterococcus spp., showed higher MIC values (2–4%). Candida albicans displayed fungistatic inhibition at 4%. Time-kill assays confirmed rapid bactericidal effects for Gram-negative isolates within 8 h at 2× MIC, while Gram-positive bacteria required prolonged exposure. Conclusions: These findings extend previous evidence of TiAB’s antimicrobial properties to gynecological pathogens, supporting its potential as a topical, non-antibiotic option for managing vaginal infections in an era of rising antimicrobial resistance. Further in vivo validation is warranted. Full article

Background and Objectives: Changes in the incidence of healthcare-associated infections (HAIs) during the coronavirus disease 2019 (COVID-19) pandemic and during periods with fewer or more COVID-19 cases have been inconclusively studied. Compared with 2015, in 2019, the abundances of the microorganisms Klebsiella pneumoniae and Enterococcus faecium increased in intensive care units (ICUs) in Taiwan. The trend in the incidence of HAIs in ICUs in Taiwan during the emergence of new infectious diseases is worth studying. Materials and Methods: We surveyed the incidence densities of different types of HAIs, device-associated HAIs, pathogens, and antimicrobial resistance in a dataset from the Taiwan Healthcare-associated Infection and Antimicrobial Resistance Surveillance System from 2015 to 2022. The change in incidence density trends was evaluated via Poisson regression, and the change in proportion trends was checked via the Mantel–Haenszel chi-square test. Results: The incidence of HAIs decreased from 5.7 to 5.17 episodes per 1000 person-days from the pre-COVID-19 period to the post-COVID-19 period. The incidences of healthcare-acquired pneumonia (HAP), device-associated HAIs decreased. However, the incidences of bloodstream infections (BSIs) increased. The percentages of patients with Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, and Acinetobacter baumannii infections significantly decreased. The percentage of patients with methicillin-resistant Staphylococcus aureus (MRSA) infection decreased, but that of patients with carbapenem-resistant K. pneumoniae (CRKP), carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Pseudomonas aeruginosa, and vancomycin-resistant Enterococcus faecium infections increased. The antimicrobial consumption related to CRKP increased and MRSA decreased. Conclusions: Overall, HAIs, HAP, and VAP decreased in incidence after the COVID-19 pandemic. These results revealed decreases in MRSA infection incidence under infection control protocols with more antimicrobial use. However, the proportion of CRKP among HAIs increased with broad-spectrum antimicrobial agent use. Based on the recent incidence of HAIs in ICUs, the quality of infection control in medical units can be enhanced to decrease HAI incidence. Full article

Background/Objectives: Epidemiological surveillance of healthcare-associated infections (HAIs) and multidrug-resistant (MDR) bacteria is a key responsibility of hospital infection control committees (HICC). Active surveillance swabs facilitate the early detection of colonized patients; helping to prevent MDR pathogen transmission in intensive care units. This study aimed to describe antimicrobial resistance profiles of bacterial isolates from clinical samples in neonatal and pediatric intensive care units. Methods: A retrospective cross-sectional study was conducted at a maternal and child hospital in Rio de Janeiro, Brazil including patients aged 0–18 years admitted to neonatal (NICU), surgical (SICU), and pediatric (PICU) intensive care units between January and December 2023. A total of 286 positive cultures were analyzed from different sample types including blood, urine, tracheal aspirates, cerebrospinal fluid (CSF), and catheter tips as well as screening swabs (nasal and rectal) for colonization surveillance. Bacterial isolates were identified and tested for antimicrobial susceptibility following BrCAST (Brazilian Committee on Antimicrobial Susceptibility Testing) guidelines. Results: Of the 286 cultures, 146 (51%) originated from the NICU, 70 (24%) from the SICU, and 70 (24%) from the PICU. Coagulase-negative staphylococci (CoNS) predominated in blood cultures, especially among neonates, while MRSA was found in all nasal swabs. Among the Gram-negative bacteria; Klebsiella pneumoniae and Pseudomonas aeruginosa were the most frequent isolates, with 30–50% resistant to third-generation cephalosporins or carbapenems. ESBL-producing organisms were found in 40% of rectal swabs. Conclusions: The predominance of CoNS in neonatal ICUs and high resistance rates among Gram-negative bacteria highlight the urgent need for continuous microbiological surveillance and antimicrobial stewardship in vulnerable pediatric populations. Full article

Background/Objectives: Antimicrobial resistance (AMR) remains a major global threat, with the COVID-19 pandemic influencing its dynamics, although its overall impact remains uncertain. This study analyzed seven-year AMR trends, including the pandemic period, in a tertiary care hospital in Greece that served as a COVID-19 referral center. Methods: Multiresistant bacteria isolated from all biological specimens of hospitalized patients between January 2018 and December 2024 were recorded and classified as multidrug- (MDR), extensively drug- (XDR), or pandrug-resistant (PDR). Overall AMR was defined as the sum of these categories. Annual incidences of overall AMR, its categories, and predominant Gram-negative (A. baumannii, K. pneumoniae, P. aeruginosa) and Gram-positive [methicillin-resistant S. aureus (MRSA), vancomycin-resistant Enterococcus (VRE)] pathogens were analyzed for the entire hospital and by sector (medical, intensive care unit [ICU], surgical). Bloodstream infection (BSI) AMR was also evaluated. Trend analysis was performed using Joinpoint regression. Results: Overall AMR exhibited a transient peak around 2021 across the hospital, except in the surgical sector. A significant rise in average annual percentage change (AAPC) occurred only in the medical sector (p < 0.001). PDR incidence increased hospital-wide (p < 0.001). K. pneumoniae, P. aeruginosa, MRSA, and VRE rose significantly in the medical sector, whereas ICU incidences remained largely stable despite the 2021 peak. A. baumannii showed no significant change. BSI-related AMR increased in the medical sector (p < 0.001) but not in the ICU (p = 0.2). Conclusions: Although overall AMR did not rise uniformly, PDR organisms increased hospital-wide. These findings support updating empiric therapy guidelines, reinforcing infection prevention measures, and translating surveillance data into targeted stewardship actions to enhance patient care. Full article

Background: Methicillin-resistant Staphylococcus aureus (MRSA) colonization is a risk factor for potential staphylococcal infection and outbreaks. Although it is recommended to obtain a swab culture to detect nasal colonization its necessity in low-prevalence countries is debated. The aim of this study was to determine the prevalence of MRSA nasal colonization, the rate of invasive infection development, and the risk factors for invasive infections in patients admitted to the intensive care unit. Materials and Methods: This retrospective study included patients who were followed up in one of the adult intensive care units at Kayseri City Training and Research Hospital between 1 January 2019 and 31 December 2024 (6 years) and from whom a culture was taken at the time of hospital admission to detect MRSA colonization in the nose. MRSA carriers were examined for the development of any invasive infection caused by MRSA within 28 days of their relevant admission. Results: Over a total period of six years, nasal swab samples were collected from 22,913 patients, and MRSA colonization was detected in 939 (4.0%). Of the patients with MRSA colonization, 32 (3.4%) were excluded from the analysis because they already had invasive MRSA infection. Additionally, 431 patients (45.8%) were excluded from the analysis because they were discharged or died within the first seven days of their admission. Consequently, invasive MRSA infection developed within 28 days in 29 of the 476 patients with MRSA colonization (6.0%). Patients who developed invasive infection had a higher rate of chronic renal failure (p < 0.001), hemodialysis (p < 0.001), central venous catheter (p = 0.028), staying in nursing home (p = 0.001), and a history of hospitalization within the last 90 days (p = 0.015). In the multivariable regression analysis, routine hemodialysis (OR: 5.216, p = 0.015), nursing home stay (OR: 3.668, p = 0.014), and a history of hospitalization within the last 90 days (OR: 2.458, p = 0.028) were found to be risk factors for developing invasive infection. The most common invasive infections were ventilator-associated pneumonia (n = 9), surgical site infection (n = 7), and catheter-related bloodstream infection (n = 6). All 29 strains were susceptible to vancomycin, linezolid, and daptomycin, while one strain was resistant to teicoplanin (3.5%). Conclusions: MRSA colonization has been detected in 4% of patients admitted to the intensive care unit. Screening should be performed because MRSA colonization may be a risk factor for invasive infections; however, screening all patients would be prohibitively expensive and labor-intensive. Instead, it may be more appropriate to identify risk factors and then screen select patients. Full article

The emergence of multidrug-resistant microbes presents a serious public health threat that requires new antimicrobial methods. A potential solution to combat resistance involves using metal nanoparticles that possess improved biological characteristics. The researchers have synthesized gold nanoparticles (Au-NPs) using gamma irradiation of Polyacrylamide (PAM) at 5, 10, and 15 kGy doses and through Au/chitosan nanocomposite production methods. They have also assessed the antimicrobial and anticancer functions of the produced nanomaterials by testing them on various microorganisms and cancer cell lines. Gold nanoparticles exhibited strong antibacterial effects against multiple Gram-positive bacterial strains, including Bacillus subtilis, Micrococcus luteus, Staphylococcus epidermidis, Staphylococcus aureus, and Streptococcus mutans, as well as methicillin-resistant Staphylococcus aureus (MRSA). Escherichia coli showed a significant inhibition zone of 23 mm, and Salmonella spp. showed similar inhibition. The inhibition zone for Klebsiella pneumoniae ATCC 13883 revealed resistance. The Au-NPs/chitosan composite showed moderate antifungal effectiveness against Syncephalis racemosum and Aspergillus niger alongside Candida albicans and several other tested fungi. Au-NPs showed cytotoxicity to breast MCF-7 cells, as well as liver HepG-2 cells and colon HCT-116 cells. The combination of Au-NPs with chitosan demonstrated limited effectiveness in countering hepatitis A virus (HAV-10) and herpes simplex virus type 1 (HSV-1). The combination of gamma-irradiated Au-NPs with biopolymers like chitosan demonstrates significant promise in antimicrobial and anticancer biomedical applications. Full article

Methicillin-resistant Staphylococcus aureus (MRSA) remains a major cause of bloodstream infection worldwide. In Korea, sequence type (ST) 72 has predominated, whereas ST8, including the USA300 lineage, has recently emerged. Comparative data on these genotypes in MRSA bacteremia (MRSAB) are limited. We conducted a retrospective cohort study of adult patients with MRSAB admitted to a 2700-bed tertiary care hospital in Republic of Korea between July 2008 and December 2020. Clinical features and outcomes of patients with ST8 MRSA were compared with those of patients with ST72 MRSA. Among 1975 cases of S. aureus bacteremia, 998 (50.5%) were due to MRSA, including 327 (32.7%) ST72 and 23 (2.3%) ST8 isolates. Demographics and comorbidities were similar, though pneumonia appeared more frequent in ST8 cases without statistical significance. ST8 isolates exhibited greater resistance to ciprofloxacin and erythromycin and more frequent vancomycin E-test MICs ≥1 mg/L, while broth microdilution MICs were comparable. spa type distribution differed, with t324 predominating in ST72 and t008 in ST8. Management practices, persistent bacteremia, recurrence, and 30- and 90-day mortality did not differ significantly. In multivariable analysis, liver cirrhosis and Charlson comorbidity index >4, but not MRSA genotype, independently predicted 30-day mortality. These findings highlight the importance of continued surveillance of emerging ST8 clones. Full article

Background: Despite efforts to rely on arteriovenous fistulas/grafts for maintenance hemodialysis, a significant number of patients still depend on tunnel hemodialysis catheters for treatment. This poses a risk factor for central line-associated bloodstream infection (CLABSI) and, subsequently, vascular access compromise. Method: We conducted a retrospective study in five dialysis centers to determine the potential factors resulting in vascular access loss, CLABSI incidence, and microbe distribution patterns in Saudi Arabia at centers under the Ministry of National Guard Health Affairs. Adults who regularly received hemodialysis and had positive blood cultures between January 2019 and December 2023 were the subjects of the study. Results: Our study identified the presence of tunnel infection (p < 0.001), the presence of a Gram-negative pathogen (p = 0.036), and a high body mass index (BMI > 30) (p = 0.04) as potential risk factors leading to the loss of tunnel central venous catheters. In contrast, there was a lower probability of central venous catheter loss due to Gram-positive pathogens (p = 0.01). The CLABSI rate was 1.55 per 100 patients per month over a five-year period. Patients with CVC required more hospital treatment and had a significantly higher rate of vascular access loss (p < 0.001). Both central and peripheral blood cultures had nearly identical microbe spectra. Methicillin-sensitive Staphylococcus aureus (MSSA), Methicillin-resistant Staphylococcus aureus (MRSA), and Staphylococcus epidermidis had the highest prevalence rates among Gram-positive organisms. Among the Gram-negative bacteria, Enterobacter cloacae was the most common, followed by Klebsiella pneumonia and Pseudomonas aeruginosa. Conclusions: Our findings indicate the need for rigorous measures and interventions to prevent Gram-negative infections and decrease the reliance on central venous catheters, to decrease infections in hemodialysis patients, and decrease morbidity and cost. Strict hand hygiene, patient education, and surveillance programs are recommended to monitor these patients. Full article