Bacteremia and Hemodialysis-Reply

In Reply.  —We have categorized Dr Bernick's interesting letter as follows:Questions and Issues Raised by Bernick That Are Answerable Merely by Reading the Article.—(1) As Table 1 shows, five of six patients had shaking chills with fever, three of six patients had emesis, one patient had leukocytosis, and one patient had a hypotensive episode. (2) As the "Results" section and Table 1 show, four patients had a single positive blood culture for P stutzeri. The fourth patient had two positive blood cultures, one drawn from the hemodialysis arterial line and the second drawn later by venipuncture. (3) One patient had concommitant bacteremia with Pseudomonas fluorescens (which was also isolated from the machine). (4) Bernick concludes that "the emphasis should not be placed on the environment but rather on the personnel responsible for its management."^1(p1912) We merely repeat our last paragraph "infection control procedures were emphasized to hemodialysis