Fariñas María Carmen, García-Palomo José Daniel, Gutiérrez-Cuadra Manuel
Unidad de Enfermedades Infecciosas, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, España.
Enferm Infecc Microbiol Clin. 2008 Oct;26(8):518-26.
Catheter-related infections in hemodialysis (HD) and peritoneal dialysis (PD) are one of the most common causes of morbidity and mortality in patients with end-stage renal disease. Staphylococcus aureus in HD patients and S. aureus and Pseudomonas aeruginosa in PD patients are the most common causative organisms isolated. Currently, the diagnostic tests with highest yield in suspected catheter-related infection in HD patients have not been established, and tests used for central venous catheters (CVC) in general are applied. Management of the infected HD catheter and the use of antimicrobial therapy are similar to the measures used for other CVCs, with some specific recommendations. Peritonitis is the most severe complication in PD patients. Improving hygiene conditions in catheter insertion, treatment of S. aureus nasal carriers, regular treatment of the catheter's exit site, and antibiotic lock therapy have been associated with a reduction of infectious episodes in HD and PD patients.
血液透析（HD）和腹膜透析（PD）相关的导管感染是终末期肾病患者发病和死亡的最常见原因之一。血液透析患者中的金黄色葡萄球菌以及腹膜透析患者中的金黄色葡萄球菌和铜绿假单胞菌是分离出的最常见病原体。目前，尚未确定血液透析患者疑似导管相关感染中检出率最高的诊断测试，一般采用用于中心静脉导管（CVC）的测试。感染的血液透析导管的管理和抗菌治疗的使用与用于其他中心静脉导管的措施相似，但有一些具体建议。腹膜炎是腹膜透析患者最严重的并发症。改善导管插入时的卫生条件、治疗金黄色葡萄球菌鼻腔携带者、定期处理导管出口部位以及抗生素封管疗法与血液透析和腹膜透析患者感染发作的减少有关。
