*4. Respect hierarchy in vascular access when using catheters for HD*

In the case of using catheters, the hierarchy of bacteremia risk is less common in subclavian catheters, jugular catheters, and femoral catheters, progressively increasing risk.

#### *5. Use the Michigan and bacteremia zero recommendations when using catheters*

When using a catheter for HD, always take the six recommendations given above from Pronovost et al. made in ICUs in Michigan and Bacteremia Zero from Spain, which reduce more than 50% of catheter-related bacteremia.

#### *6. Nasal cultures for all ESRD patients*

Nasal cultures for *S. aureus*for new patients and serial cultures for chronic patients and use of nasal mupirocin are recommended.

#### *7. Inspect and clean catheter exit sites*

Exit sites should be routinely inspected for infection at every dialysis session, and subjected to swabbing and bacterial culture whenever infection is suspected.
