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

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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.

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Acknowledgements

We express our gratefulness to the medical, nursing and secretarial staff from the Nephrology Department, St. Bortolo Hospital, Vicenza. We thank Associazione Amici del Rene Vicenza (A.A.R.VI) ONLUS.

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Correspondence to Grazia Maria Virzì.

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Conflict of interest

No authors have reported a conflict of interest. This manuscript was seen and approved by all authors listed. It is not under consideration for publication elsewhere in a similar form, in any language, except in abstract form.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Ethics Committee of San Bortolo Hospital in Vicenza.

Informed consent

All the patients or their relatives were informed about the experimental protocol and the objectives of the study before providing informed consent and blood samples. Informed consent was obtained from all individual participants included in the study.

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Milan Manani, S., Virzì, G., Giuliani, A. et al. Catheter-related infections in peritoneal dialysis: comparison of a single center results and the literature data. J Nephrol 32, 837–841 (2019). https://doi.org/10.1007/s40620-019-00604-3

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  • DOI: https://doi.org/10.1007/s40620-019-00604-3

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