{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T15:01:58Z","timestamp":1786719718426,"version":"build-2736575974"},"reference-count":13,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Bloodstream infections cause significant complications for haemodialysis (HD) patients and increase healthcare costs. Infection prevention and control bundles are continually evolving to reduce bloodstream infections. This study aims to describe the change in the microbiology of HD bloodstream infections at our centre. We also describe how changes in infection prevention and control bundles are associated with changes in the microbiology of bloodstream infections in HD patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective longitudinal cohort study and analysed blood cultures and clinical data from 2009 to 2023 in a large Irish hospital. Data were collected from the electronic patient records. Positive blood cultures were categorised by microorganism. Episodes of bloodstream infection per 100 patient-years were calculated at yearly intervals and compared over time. An interrupted time series analysis incorporating incidence rate ratios (IRR) was performed to assess the impact of three infection prevention and control interventions on bloodstream infections in our cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1248 HD patients were included in the study, among whom 522 episodes of bloodstream infections occurred.<\/jats:p>\n                    <jats:p>The proportion of bloodstream infections caused by staphylococci (Staphylococcus aureus and coagulase-negative staphylococcus) decreased over the course of the study (60% in 2009\u20132011 to 34.8% in 2021\u20132023) and while the proportion caused by gram-negative rods rose (18.5% in 2009\u20132011 to 43.9% In 2021\u20132023).<\/jats:p>\n                    <jats:p>Age &amp;gt;34 years, male gender (IRR 1.43, P &amp;lt; .001), and access via central venous catheter (CVC) were all associated with increased risk of bloodstream infections.<\/jats:p>\n                    <jats:p>The opening of a new dialysis unit had the greatest effect on the reduction of bloodstream infections ((S. aureus IRR = 0.42, P &amp;lt; .001) and (gram-negative rods IRR = 0.49, P .048)).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The epidemiology of bloodstream infections in HD patients is changing. There has been a shift from gram-positive-predominant to gram-negative-predominant bloodstream infections among our HD cohort.<\/jats:p>\n                    <jats:p>The opening of a new dialysis unit had the greatest temporal association with the decrease in both S. aureus and gram-negative rod bloodstream infections in this study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/joneph\/aajag171","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T11:36:23Z","timestamp":1782214583000},"source":"Crossref","is-referenced-by-count":0,"title":["Declining rates of bloodstream infections among haemodialysis patients and the temporal association with changes in infection, prevention and control bundles of care between 2009 and 2023"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5375-0923","authenticated-orcid":false,"given":"Peter","family":"Conlon","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Beaumont Hospital , Dublin ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mairead","family":"Skally","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Beaumont Hospital , Dublin ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eoghan","family":"de Barra","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Beaumont Hospital , Dublin ,","place":["Ireland"]},{"name":"Department of International Health and Tropical Medicine, RCSI , Dublin ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"O\u2019Kelly","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Beaumont Hospital , Dublin ,","place":["Ireland"]},{"name":"Royal College of Surgeons in Ireland, RCSI , Dublin ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Greene","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Beaumont Hospital , Dublin ,","place":["Ireland"]},{"name":"Royal College of Surgeons in Ireland, RCSI , Dublin ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3204-5962","authenticated-orcid":false,"given":"Fidelma","family":"Fitzpatrick","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Beaumont Hospital , Dublin ,","place":["Ireland"]},{"name":"Department of Clinical Microbiology, RCSI , Dublin ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J","family":"Conlon","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Beaumont Hospital , Dublin ,","place":["Ireland"]},{"name":"Royal College of Surgeons in Ireland, RCSI , Dublin ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"2026081409550301000_aajag171-B1","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1186\/1471-2369-15-185","article-title":"Prevalence and variation of chronic kidney disease in the Irish health system: initial findings from the national kidney disease surveillance programme","volume":"15","author":"Stack","year":"2014","journal-title":"BMC Nephrol"},{"key":"2026081409550301000_aajag171-B2","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1053\/j.ajkd.2010.04.016","article-title":"Infection-related hospitalizations in older patients with ESRD","volume":"56","author":"Dalrymple","year":"2010","journal-title":"Am J Kidney Dis"},{"key":"2026081409550301000_aajag171-B3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1086\/599376","article-title":"Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Diseases Society of America","volume":"49","author":"Mermel","year":"2009","journal-title":"Clin Infect Dis."},{"key":"2026081409550301000_aajag171-B4","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1016\/j.jiph.2016.06.008","article-title":"Hemodialysis catheter-related infection: rates, risk factors and pathogens","volume":"10","author":"Sahli","year":"2017","journal-title":"J Infect Public Health"},{"key":"2026081409550301000_aajag171-B5","doi-asserted-by":"publisher","first-page":"1202","DOI":"10.1093\/ndt\/gfv205","article-title":"Gram-negative bacteraemia in haemodialysis","volume":"30","author":"Murray","year":"2015","journal-title":"Nephrol Dial Transplant"},{"key":"2026081409550301000_aajag171-B6","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1186\/s12882-019-1253-x","article-title":"Determinants and \u00adoutcomes of access-related blood-stream infections among\u00a0Irish haemodialysis patients; 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