Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Via Rodolfi, 37, 36100, Vicenza, Italy.
IRRIV, International Renal Research Institute Vicenza (IRRIV), Vicenza, Italy.
J Nephrol. 2019 Oct;32(5):837-841. doi: 10.1007/s40620-019-00604-3. Epub 2019 Apr 6.
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.
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.
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.
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.
导管相关性感染是腹膜透析（PD）患者发病率的重要原因。有不同的出口部位护理方案可预防导管相关性感染。本研究旨在评估我们 PD 中心导管相关性感染及其并发症的发生率。
我们对中心所有 PD 患者进行了回顾性、观察性研究。我们每年对现患患者进行观察，为期 5 年。患者每周进行三次出口部位护理，用 10%次氯酸钠清洁出口部位。自 2017 年起，ISPD 建议更新建议应用抗生素乳膏。我们记录了 ESI 和 TI 的发生率、庆大霉素耐药、导管丢失、ESI 后相关性腹膜炎和真菌感染，并且将我们的结果与文献中的数据进行了比较。
每年现患患者为 117.6±5.5。“风险时间”为 356.46 年。我们的 TESI（隧道和出口部位感染）、TI、庆大霉素耐药、ESI 后相关性腹膜炎和真菌感染率的中位数与文献数据相似。我们患者的 ESI 和感染导致的导管丢失明显较低。未报告皮肤过敏或不耐受等严重不良反应。
我们的结果证实了使用 10%次氯酸钠进行常规出口部位护理的有效性和安全性。该方案与文献中报告的数据相似。我们对文献的分析强调了 ESI 和 TI 的感染率存在广泛差异。
