Persistent colonization of exit site is associated with modality failure in peritoneal dialysis

Author:

Nadarajah Luxme12ORCID,Yaqoob Muhammed M12,Fan Stanley1

Affiliation:

1. Department of Renal Medicine and Transplantation, Barts Health NHS Trust, London, UK

2. Translational Medicine and Therapeutic, William Harvey Research Institute, Queen Mary University, London, UK

Abstract

Exit-site infections (ESIs) increase the risk of developing peritoneal dialysis (PD) peritonitis and PD technique failure. There are no clear guidelines on how to monitor exit site (ES) after ESI with Staphylococcus aureus or Pseudomonas. We report on a 1-year observational study of 23 patients who developed an ESI with one of these serious pathogens. After completing initial antibiotic treatment, swabs were taken every month for 3 months. Primary treatment cure occurred in 19/23 (83%). Colonization of ES after primary cure occurred in 8/19 (42%) patients. In the eight colonized patients, five had subsequent PD technique failure due to infections. By contrast, during an average follow-up period of 7.2 months, none of the 11 patients who were proven noncolonized developed PD technique failure from infections; HR (colonized vs. noncolonized) = 10.89, 95% CI 2.6–45.43, p < 0.05. In conclusion, colonization significantly increased the risk of catheter loss. Increased surveillance and aggressive treatment may ameliorate this risk.

Publisher

SAGE Publications

Subject

Nephrology,General Medicine

Cited by 5 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Best Practice of Peritoneal Dialysis-Associated Gram-Negative Peritonitis in Children: Insights From the International Pediatric Peritoneal Dialysis Network Registry;Kidney International Reports;2024-06

2. Management of peritoneal dialysis related infections;Hospital Pharmacology - International Multidisciplinary Journal;2024

3. ISPD Catheter-related Infection Recommendations: 2023 Update;Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis;2023-05

4. Reducing and treating peritoneal dialysis catheter-related infections: Nursing implementation from evidence to practice;Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis;2023-05

5. Epidemiology, management, and prevention of exit site infections in peritoneal dialysis patients;Therapeutic Apheresis and Dialysis;2021-09-07

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