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End stage renal disease (ESRD) patients on renal replacement therapy (RRT) have an increased risk of morbidity and mortality due to healthcare associated infections (HCAIs). The aim of this study is to determine the prevalence, microbial etiology, and risk factors associated with HCAIs among ESRD patients on RRT. A multicenter, retrospective study was conducted from June to December 2019. ESRD patients with minimum of 6 months on RRT were included, while pregnant patients and patients <18 years were excluded. To reduce the risk of selection bias, all patients were randomly selected using a simple random sampling technique. The prevalence showing the proportion of patients that acquired HCAI since the initiation of dialysis until 2019 was calculated using the European patients' academy (EUPATI) formula. Risk factors were assessed using univariate and multivariate regression analysis. The prevalence of HCAI among ESRD patients was 174/400 (43.5%). Catheter related bloodstream infection (CRBSI) was the most common infection [64(36.8%)], followed by peritonitis [45(25.8%)] and pneumonia [37(21.2%)]. Out of 382 total pathogens identified, 204 (53.4%) were Gram positive and 162 (42.4%) were Gram negative. Both methicillin sensitive staphylococcus aureus (MSSA) and methicillin resistant staphylococcus aureus (MRSA) showed statistically significant associations (p<0.05) with CRBSI. Use of multiple accesses, increased blood sugar levels, low serum sodium levels and higher CRP concentration increased the occurrence of HCAIs. The burden of HCAIs among the patients undergoing RRT is high. Preventive strategies and optimum empirical therapy of antibiotics should be used to reduce the risk of these infections among ESRD patients. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study is to compare and analyze the survival distributions of the different categories of the socio-economic and laboratory variables of the ESRD patients. Through which we can see the difference between the categories of the individual categorical variable with respect to the survival distributions. Data Sources: The sample of 40 patients was taken from the two hospitals of Lahore city. Jinnah Hospital Lahore. Lahore General Hospital, Lahore. Design of the Study: The sample methodology of the study is the convenience sampling6. Data Collection: The questionnaire was used to collect the primary data from the patients. Period of the Study: All the patients were followed up during the study duration of 122 days. Materials and Methods: To examine the significant difference in the different categories of the socio-economic and laboratory variables with respect to the survival distribution the Kaplan- Meier method is used. To illustrate the survival distributions the survival curve and hazard curve were used2. Results: All the p-values of socio-economic and laboratory are very large except the p-value of the Serum Albumin which is very small and less than 0.05 level of significance. The categories of all the laboratory variables were classified into "Normal values Range" and "Other values out of range values". The categories of the Serum Albumin are significantly different. Conclusions: It is concluded that the survival distributions of all the categorical variables are equal and do not differ significantly. Furthermore the laboratory variable Serum Albumin is significantly differing by the log rank test2. So it is clear indication that the serum albumin is not the status variable of nutrition. [ABSTRACT FROM AUTHOR]