Catheter-related infections in peritoneal dialysis: comparison of a single center results and the literature data

J Nephrol. 2019 Oct;32(5):837-841. doi: 10.1007/s40620-019-00604-3. Epub 2019 Apr 6.

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.

Keywords: 10% Sodium hypochlorite; Exit site care; Exit site infection; Peritoneal dialysis; Tunnel infection.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Aged
  • Catheter-Related Infections / epidemiology*
  • Catheter-Related Infections / etiology*
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Peritoneal Dialysis / adverse effects*
  • Retrospective Studies