ISPD Catheter-related Infection Recommendations: 2023 Update

Author:

Chow Kai Ming12ORCID,Li Philip Kam-Tao12ORCID,Cho Yeoungjee34ORCID,Abu-Alfa Ali56,Bavanandan Sunita7,Brown Edwina A8ORCID,Cullis Brett9ORCID,Edwards Dawn10,Ethier Isabelle1112,Hurst Helen13ORCID,Ito Yasuhiko14,de Moraes Thyago Proença15ORCID,Morelle Johann16,Runnegar Naomi17,Saxena Anjali1819,So Simon Wai-Yin20,Tian Na21,Johnson David W34ORCID

Affiliation:

1. Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong

2. Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong

3. Australasian Kidney Trials Network, University of Queensland, Brisbane, Australia

4. Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia

5. Division of Nephrology and Hypertension, American University of Beirut, Lebanon

6. Section of Nephrology, Yale School of Medicine, New Haven, CT, USA

7. Department of Nephrology, Hospital Kuala Lumpur, Malaysia

8. Imperial College Renal and Transplant Centre, Imperial College NHS Trust, London, UK

9. Department of Nephrology and Child Health, University of Cape Town, South Africa

10. National Forum of ESRD Networks, Kidney Patient Advisory Council (KPAC), USA

11. Division of Nephrology, Centre hospitalier de l’Université de Montréal, Canada

12. Health Innovation and Evaluation Hub, Centre de recherche du Centre hospitalier de l’Université de Montréal, Canada

13. School of Health and Society, University of Salford, Salford Royal, Northern Care Alliance Trust, UK

14. Department of Nephrology and Rheumatology, Aichi Medical University, Nagakute, Japan

15. Programa de Pós-Graduação em Ciências da Saúde, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil

16. Division of Nephrology, Cliniques universitaires Saint-Luc, Brussels, Belgium

17. Infectious Management Services, Princess Alexandra Hospital, University of Queensland, Brisbane, Australia

18. Department of Medicine, Division of Nephrology, Stanford University, CA, USA

19. Department of Medicine, Division of Nephrology, Santa Clara Valley Medical Center, San Jose, CA, USA

20. Department of Pharmacy, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong

21. Department of Nephrology, General Hospital of NingXia Medical University, Yinchuan, China

Abstract

Peritoneal dialysis (PD) catheter-related infections are important risk factors for catheter loss and peritonitis. The 2023 updated recommendations have revised and clarified definitions and classifications of exit site infection and tunnel infection. A new target for the overall exit site infection rate should be no more than 0.40 episodes per year at risk. The recommendation about topical antibiotic cream or ointment to catheter exit site has been downgraded. New recommendations include clarified suggestion of exit site dressing cover and updated antibiotic treatment duration with emphasis on early clinical monitoring to ascertain duration of therapy. In addition to catheter removal and reinsertion, other catheter interventions including external cuff removal or shaving, and exit site relocation are suggested.

Publisher

SAGE Publications

Subject

Nephrology,General Medicine

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