A 31-year-old patient came to visit the outpatient clinic at the hospital for his routine twice-weekly hemodialyis (HD) session. During HD, the patient suddenly developed a fever with shivering. At that time, a diagnosis of catheter-related blood stream infection (CR-BSI) was developed, HD catheter or the catheter double lumen (CDL) was uninstalled and the patient was hospitalized. Results of culture withdrawn through the tip of catheter lumen and peripheral blood revealed identical microorganism, i.e. the Enterobacter cloacae. Diagnosis of CR-BSI in the present case was made based on the 2009 Infectious Disease Society of America (IDSA) criteria. In general, prevention measures for CR-BSI should be taken into account including education for patient, awareness of the health care providers who install the CDL, implementation of procedure for appropriate skin aseptic technique and best practice for HD catheter care, particularly on the exit site of the CDL to prevent the development of CR-BSI.

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Seorang pasien pria usia 31 tahun, datang berobat jalan ke rumah sakit untuk hemodialisis (HD) rutin 2 kali dalam seminggu. Saat dilakukan tindakan HD mendadak pasien demam dan menggigil, saat itu ditegakkan diagnosis catheter-related blood stream infection (CR-BSI), dilakukan pencabutan catheter double lumen (CDL) dan pasien kemudian dirawat. Hasil kultur tip CDL dan kultur darah perifer didapatkan kuman yang sama yaitu Enterobacter cloacae. Diagnosis CR-BSI pada kasus ini ditegakkan berdasarkan kriteria Infectious Disease Society of America (IDSA) tahun 2009. Secara keseluruhan harus diperhatikan langkah pencegahan CR-BSI berupa edukasi pasien dan petugas yang memasang CDL, penerapan prosedur tindakan aseptik kulit yang benar serta perawatan exit site CDL, untuk mencegah terjadinya CR-BSI.