Sabrina Milan Manani1,2, Grazia Maria Virzì3,4, Anna Giuliani1,2, Carlo Crepaldi1,2, Claudio Ronco1,2,5. 1. Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Via Rodolfi, 37, 36100, Vicenza, Italy. 2. IRRIV, International Renal Research Institute Vicenza (IRRIV), Vicenza, Italy. 3. Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Via Rodolfi, 37, 36100, Vicenza, Italy. graziamaria.virzi@aulss8.veneto.it. 4. IRRIV, International Renal Research Institute Vicenza (IRRIV), Vicenza, Italy. graziamaria.virzi@aulss8.veneto.it. 5. Department of Medicine, University of Padua, Padua, Italy.
Abstract
BACKGROUND: Catheter-related infections are important causes of morbidity in patients undergoing peritoneal dialysis (PD). There are different protocols of exit site care for the prevention of catheter-related infections. The aim of this study was to evaluate the incidence of catheter-related infections and their complications in our PD center. METHODS: We performed a retrospective, observational study for all patients receiving PD in our center. We observed prevalent patients every year for 5 years. The patients performed the exit-site care three times a week, cleaning the exit site with 10% sodium hypochlorite. From 2017, update of ISPD recommendations suggests the application of antibiotic creams. We recorded the incidence rate of ESI and TI, gentamicin resistance, catheter lost, related post-ESI peritonitis and fungal infections, and we compared our results with the data in the literature. RESULTS: Prevalent patients per year were 117.6 ± 5.5. The "time at risk" was 356.46 years. The median values of TESI (tunnel and exit site infections), TI, gentamicin resistance, related post-ESI peritonitis and fungal infection rate were similar in our results and the literature data. The ESI and the catheter lost caused by infection were significantly lower in our patients. No significant adverse effects, such as skin allergy or intolerance, were reported. CONCLUSIONS: Our results confirm the utility and the safety of routinely exit site care using 10% sodium hypochlorite. This protocol resulted similar to the data reported in the literature. Our analysis of the literature highlighted the wide variation in the infection rate of ESI and TI.
BACKGROUND: Catheter-related infections are important causes of morbidity in patients undergoing peritoneal dialysis (PD). There are different protocols of exit site care for the prevention of catheter-related infections. The aim of this study was to evaluate the incidence of catheter-related infections and their complications in our PD center. METHODS: We performed a retrospective, observational study for all patients receiving PD in our center. We observed prevalent patients every year for 5 years. The patients performed the exit-site care three times a week, cleaning the exit site with 10% sodium hypochlorite. From 2017, update of ISPD recommendations suggests the application of antibiotic creams. We recorded the incidence rate of ESI and TI, gentamicin resistance, catheter lost, related post-ESI peritonitis and fungal infections, and we compared our results with the data in the literature. RESULTS: Prevalent patients per year were 117.6 ± 5.5. The "time at risk" was 356.46 years. The median values of TESI (tunnel and exit site infections), TI, gentamicin resistance, related post-ESI peritonitis and fungal infection rate were similar in our results and the literature data. The ESI and the catheter lost caused by infection were significantly lower in our patients. No significant adverse effects, such as skin allergy or intolerance, were reported. CONCLUSIONS: Our results confirm the utility and the safety of routinely exit site care using 10% sodium hypochlorite. This protocol resulted similar to the data reported in the literature. Our analysis of the literature highlighted the wide variation in the infection rate of ESI and TI.
Entities:
Keywords:
10% Sodium hypochlorite; Exit site care; Exit site infection; Peritoneal dialysis; Tunnel infection
Authors: Denise J Campbell; Fiona G Brown; Jonathan C Craig; Martin P Gallagher; David W Johnson; Geoffrey S Kirkland; Subramanian K Kumar; Wai H Lim; Dwarakanathan Ranganathan; Walaa Saweirs; Kamal Sud; Nigel D Toussaint; Rowan G Walker; Lesley A Williams; Maha Yehia; David W Mudge Journal: Nephrol Dial Transplant Date: 2015-04-22 Impact factor: 5.992
Authors: Clara Santos; Miguel Pérez-Fontán; Ana Rodríguez-Carmona; María Calvo-Rodríguez; Andrés López-Muñiz; Beatriz López-Calviño; Teresa García-Falcón Journal: Perit Dial Int Date: 2014-10-07 Impact factor: 1.756
Authors: Francesca Martino; Z Adıbelli; G Mason; A Nayak; W Ariyanon; E Rettore; Carlo Crepaldi; Mariapia Rodighiero; Claudio Ronco Journal: Blood Purif Date: 2014-07-09 Impact factor: 2.614
Authors: Lei Zhang; Sunil V Badve; Elaine M Pascoe; Elaine Beller; Alan Cass; Carolyn Clark; Janak de Zoysa; Nicole M Isbel; Steven McTaggart; Alicia T Morrish; E Geoffrey Playford; Anish Scaria; Paul Snelling; Liza A Vergara; Carmel M Hawley; David W Johnson Journal: Perit Dial Int Date: 2015-07-29 Impact factor: 1.756