scholarly journals Comparison of exit site infection frequency between Continuous Ambulatory Peritoneal Dialysis and Automated Peritoneal Dialysis patients: A single center experience

2019 ◽  
Author(s):  
Mustafa Sevinc
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Infection Frequency ◽  
Site Infection ◽  
Automated Peritoneal Dialysis ◽  
Single Center ◽  
Dialysis Patients ◽  
Exit Site ◽  
Exit Site Infection ◽  
Single Center Experience

Prophylaxis against Gram-Positive Organisms Causing Exit-Site Infection and Peritonitis in Continuous Ambulatory Peritoneal Dialysis Patients by Applying Mupirocin Ointment at the Catheter Exit Site

2003 ◽  
Vol 23 (2_suppl) ◽  
pp. 153-158 ◽  
Author(s):  
Sunny S.H. Wong ◽  
Kwok Hong Chu ◽  
Au Cheuk ◽  
Wai Kay Tsang ◽  
Samuel K.S. Fung ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Local Application ◽  
Diabetic Patients ◽  
Site Infection ◽  
Dialysis Patients ◽  
Exit Site ◽  
Gram Positive ◽  
Exit Site Infection ◽  
Mupirocin Ointment

Objective We evaluated the effectiveness of local application of mupirocin ointment at the catheter exit site in preventing exit-site infection and peritonitis attributable to gram-positive organisms in continuous ambulatory peritoneal dialysis patients. Methods This prospective randomized controlled trial included 154 patients. They were randomly allocated to a mupirocin-treated group (group M) and a control group (group C). Group M included 73 patients (47.4%) who were instructed to apply mupirocin ointment to the catheter exit site once daily after the routine daily exit-site dressing. Group C included 81 patients (52.6%) who continued their usual daily exit-site care without applying mupirocin. The two groups were followed to see whether there would be any difference in the frequency of exit-site infection and peritonitis or in the infecting organisms. Results Interim data were collected at 5 months after the start of the study. Those data showed a significantly lower incidence of exit-site infection and peritonitis attributable to gram-positive organisms in group M as compared with group C. The incidence of gram-positive exit-site infection in group C was 1 episode per 36.8 patient–months; in group M, the incidence was 1 episode per ∞ patient–months (0 incidence in 5 months, p < 0.05). The incidence of gram-positive peritonitis in group C was 1 episode per 40.5 patient–months; in group M, the incidence was 1 episode per 365 patient–months ( p < 0.05). Mupirocin treatment had no significant effect on the incidence of exit-site infection and peritonitis attributable to other organisms. Before mupirocin treatment, we saw a trend toward higher infection rates in diabetic patients and nasal carriers of Staphylococcus aureus as compared with non diabetic patients and nasal non carriers, although the differences were not statistically significant. Mupirocin brought the infection rate attributable to gram-positive organisms to an equally low level in diabetic and non-diabetic patients, and in nasal carriers and nasal non carriers of S. aureus. No adverse effect of local application of mupirocin was reported. Conclusion Local application of mupirocin ointment at the catheter exit site is a safe and effective method of preventing exit-site infection and peritonitis involving gram-positive organisms.

scholarly journals Pseudomonas exit site infections in continuous ambulatory peritoneal dialysis patients.

1992 ◽  
Vol 2 (10) ◽  
pp. 1498-1501
Author(s):  
H R Kazmi ◽  
F D Raffone ◽  
A S Kliger ◽  
F O Finkelstein
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Catheter Removal ◽  
Site Infection ◽  
Dialysis Patients ◽  
Exit Site ◽  
Exit Site Infection ◽  
Retrospective View ◽  
History Of ◽  
Oral Ciprofloxacin

The purpose of this study is to examine the natural history of Pseudomonas aeruginosa exit site infections in continuous ambulatory peritoneal dialysis (CAPD) patients treated with oral ciprofloxacin and local exit site care. A retrospective view was undertaken of 18 episodes of P. aeruginosa exit site infections developing in 17 patients maintained on CAPD during 1989 and 1990. Standardized therapy for the exit site infection consisted of oral ciprofloxacin (500 mg twice daily) and local exit site care with antiseptic agents. Fifteen (83%) of 18 of the pseudomonas exit site infections resolved with therapy. Three episodes (17%) required catheter removal to successfully eradicate the infection. Four of the 15 patients whose exit site infections resolved developed P. aeruginosa peritonitis 2 to 9 months after the clinical resolution of the exit site infection. The majority of pseudomonas exit site infections in CAPD patients can be successfully treated with oral ciprofloxacin and local care. Approximately 17% of the patients in this study required catheter removal to successfully eradicate the infection and an additional 22% of the patients developed pseudomonas peritonitis several months after the resolution of the exit site infection.

Chronic Peritoneal Dialysis—A Single-Center Experience

2003 ◽  
Vol 23 (2_suppl) ◽  
pp. 188-191 ◽  
Author(s):  
Ghulam H. Malik ◽  
Ali Swaid Al-Harbi ◽  
Suleiman A. Al-Mohaya ◽  
Raed Al-Awaishe ◽  
Mohammad C. Kechrid ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Peritoneal Dialysis ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Site Infection ◽  
Exit Site ◽  
Exit Site Infection ◽  
Single Center Experience ◽  
Age Range

Objective In Saudi Arabia, experience with continuous ambulatory peritoneal dialysis (CAPD) as a renal replacement therapy is limited, and publications are scanty. The present study was undertaken to evaluate CAPD in the Saudi population. Patients and Methods All patients managed by CAPD from May 1993 to September 2002 were included in the study. Tenckhoff indwelling silicone-rubber double-cuff catheters were surgically implanted. Peritoneal dialysis (PD) was started 2 weeks after catheter insertion. Generally, 2-L exchanges 4 times daily were used. Our total of 91 PD patients included 50 men in the age range 13 – 80 years (mean: 48 ± 18 years), and 41 women in the age range 16 – 76 years (mean: 52 ± 18 years). Forty-nine patients performed dialysis by themselves; 42 patients needed a helper. Results Between April 2001 and September 2002, we noted, on average, 1 episode of peritonitis per 21 patient–months and 1 episode of exit-site infection per 24 patient–months. The most common causative organisms for peritonitis were Pseudomonas (16%), Staphylococcus epidermidis (16%), and Staphylococcus aureus (7%). No organisms were grown in 13% of peritonitis episodes. The organisms most commonly responsible for exit-site infection were Pseudomonas aeruginosa (50%) and Staphylococcus (31%). We removed catheters from 32 patients, 12 of those for mechanical reasons. Of the 20 patients whose catheter was removed for infection, P. aeruginosa was cultured in 11 cases. Nine of 23 patients switched to hemodialysis were switched for refractory peritonitis. By the end of the study, 38 patients were still on CAPD, 23 had been switched to hemodialysis, 10 had undergone renal transplantation, and 20 had died. The major causes of death were peritonitis with sepsis ( n = 6), cardiovascular causes ( n = 5), and sudden death at home or in other hospitals ( n = 5). Conclusion Continuous ambulatory peritoneal dialysis is a viable option of renal replacement therapy in Saudi Arabia. The main problem encountered was peritonitis.

Peritoneal Dialysis in Adult Patients with Permanent Suprapubic Catheter: A Single-Center Experience and Literature Review

2018 ◽  
Vol 38 (6) ◽  
pp. 424-429 ◽  
Author(s):  
Abdullah K. Al-Hwiesh ◽  
Ibrahiem Saeed Abdul-Rahman ◽  
Mohammad Ahmed Nasr El-Din ◽  
Amani Al-Hwiesh ◽  
Aisha Alosail ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Suprapubic Catheter ◽  
Site Infection ◽  
Single Center ◽  
Exit Site ◽  
Exit Site Infection ◽  
Single Center Experience ◽  
Number Of Patients ◽  
The Difference

Background The aim of this paper was to review the feasibility of peritoneal dialysis (PD) in the presence of a permanent supra-pubic catheter over a long follow-up period. Methods Twelve patients with automated PD and permanent suprapubic catheters were studied for complications over a period of 10 years. Results In all 12 patients, PD went smoothly. Two of our patients required removal of the PD catheter due to peritonitis. The overall rate of exit-site infection throughout the study was 41.7/patient-month and the difference between patients 60 years or older and those 25 years or younger was not significant ( p = 0.3673). The overall peritonitis rate for all patients was 38.3 episode/patient-month, and none of the patients with ventriculoperitoneal shunt (VPS) had peritonitis. All patients with episodes of infection responded well to the proper antibiotics. Conclusions The available data supported the feasibility of PD in patients with permanent suprapubic catheters; however, a greater number of patients with a longer follow-up period need to be studied to support our results.

Subcutaneous Cuff Migrates after Initiation of Peritoneal Dialysis

2018 ◽  
Vol 38 (3) ◽  
pp. 229-231
Author(s):  
Tsutomu Sakurada ◽  
Hitoshi Kotake ◽  
Kenichiro Koitabashi ◽  
Yugo Shibagaki
Keyword(s):  
Diabetes Mellitus ◽  
Peritoneal Dialysis ◽  
Retrospective Study ◽  
Site Infection ◽  
Background Characteristics ◽  
Single Center ◽  
Exit Site ◽  
Exit Site Infection ◽  
Factors Affecting ◽  
History Of

The aim of this study was to determine whether subcutaneous cuffs migrate toward the exit site after initiation of peritoneal dialysis (PD) and to clarify the factors affecting such migration. Subcutaneous cuff migration was defined as extension of the length of the external catheter. In this single-center, retrospective study, the external catheter lengths at initiation and 1 year later were compared in 33 PD patients (median age 62 years; 64% men; 49% with diabetes mellitus). The correlations between patient background characteristics at initiation and extension of catheter length were also examined. The external catheter length was significantly extended at 1 year later (13.5 vs 15.0 cm, p < 0.001). There was no relationship between a history of exit-site infection and extension of catheter length ( p = 0.250). Hemoglobin (r = -0.447, p = 0.009), serum albumin (r = -0.377, p = 0.031), and external catheter length at initiation (r = -0.350, p = 0.046) showed negative correlations with extension. In conclusion, subcutaneous cuff migration was observed in just 1 year and may be associated with malnutrition, anemia, and short external catheter length at initiation of PD.

Comparison of Exit -Site Infections in Disconnect versus Nondisconnect Systems for Peritoneal Dialysis

1992 ◽  
Vol 12 (3) ◽  
pp. 317-320 ◽  
Author(s):  
John M. Burkart ◽  
Jean R. Jordan ◽  
Theresa A. Durnel ◽  
L. Douglas Case
Keyword(s):  
Peritoneal Dialysis ◽  
Marked Reduction ◽  
Site Infection ◽  
Automated Peritoneal Dialysis ◽  
Infection Rates ◽  
Exit Site ◽  
Endstage Renal Disease ◽  
Exit Site Infection ◽  
Dialysis Unit ◽  
Private Setting

Objective To determine if disconnect systems reduce the incidence of exit-site infections when compared to nondisconnect systems. Design We prospectively monitored exit-site infections and peritonitis rates in 96 disconnect patients (Yset, automated peritoneal dialysis (APD)) and 60 nondisconnect patients (spike, ultraviolet connection device (UVXD)). Setting A freestanding chronic peritoneal dialysis unit staffed by physicians from both a medical school and a private setting. Patients All patients who began peritoneal dialysis at our unit were monitored, regardless of cause of endstage renal disease (ESRD) or age. Intervention Patients were dialyzed using the system (Y-set, spike, etc.) most appropriate for their life-style and their ability to administer self-care. Main Outcome We attempted to follow disconnect and nondisconnect patients for a similar median time on dialysis and compared differences in exit-site infections. Results Peritonitis rates (episodes/pt year) were reduced for disconnect (0.60) versus nondisconnect (0.99) systems (p=0.0006). Despite the marked reduction in peritonitis rates, there was no difference in exit-site infection rates (0.35 vs 0.38), the time to the first exit -site infection, or the time to the first catheter removal for disconnect versus nondisconnect groups. When individual systems were compared, differences in exit-site infection rates (episodes/pt years) were noted (0.62, spike; 0.26,UVXD; 0.32,Y-set; 0.41,APD). Conclusion We found no overall difference in exit site infection rates for disconnect versus nondisconnect systems, despite a reduction in peritonitis rates for disconnect systems.

Peritonitis in Continuous Ambulatory Peritoneal Dialysis {CAPD): A Multi-Centre Randomized Clinical Trial Comparing the Y Connector Disinfectant System to Standard Systems

1989 ◽  
Vol 9 (3) ◽  
pp. 159-163 ◽  
Author(s):  
◽  
O.N. Churchil ◽  
O.W. Taylor ◽  
S.I. Vas ◽  
O.G. Oreopoulos ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Peritoneal Dialysis ◽  
Risk Reduction ◽  
Randomized Clinical Trial ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Standard Group ◽  
Site Infection ◽  
Confidence Limits ◽  
Exit Site ◽  
Exit Site Infection

sixty-one new continuous ambulatory peritoneal dialysis (CAPD) patients were allocated to a Y connector disinfectant (Amuchina, Italy) and 63 to standard systems (Baxter Systems II & III) in a randomized clinical trial addressing peritonitis rates in 8 CAPD programs in 6 Canadian cities. In the Y connector-disinfectant group, 15 patients experienced 21 episodes of peritonitis in 452 patient-months or 1 per 21.53 patient-months. In the standard systems group, 30 patients experienced 47 episodes of peritonitis in 467 patient-months or 1 per 9.93 patient-months ( p = 0.009). The peritonitis risk reduction was 61% (95% confidence limits 27–79%). Exit-site infections occurred in 36% of each group. Prior to the development of exit -site infection, the monthly risk for peritonitis was 3.12% for the Y connector disinfectant system and 7.37% for the standard system. After an exit -site infection, these probabilities increased to 6.15% and 15.47%, respectively. Skin organisms were responsible for peritonitis in 8/21 (38%) in the Y connector-disinfectant group and 30/47 (64%) in the standard group. There were 75 days hospitalized for peritonitis in the Y connector-disinfectant group compared to 257 days for the standard group. The Y connector disinfectant system decreases the peritonitis rate through its effect on skin organisms. Exit -site infections are a major source of organisms responsible for peritonitis.

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