Wilson A P, Scott G M, Lewis C, Neild G, Rudge C
Department of Clinical Microbiology, University College Hospital, London, UK.
J Hosp Infect. 1994 Dec;28(4):265-71. doi: 10.1016/0195-6701(94)90090-6.
The major cause of failure of continuous ambulatory peritoneal dialysis is peritoneal or exit site infection with Staphylococcus aureus. From 1989-1992, eradication of nasal and perineal carriage, continued use of an occlusive dressing to the exit site, improved aseptic technique for dressing changes by the patient and avoidance of wetting of the dressing were used in an attempt to reduce staphylococcal infections. By comparison with the 3-year period prior to intervention, a significant increase in the life of the catheters was achieved (removed at 1 year, 13 vs. 28%, P < 0.001) with a reduction in episodes of peritonitis due to S. aureus. The study was not prospectively controlled but there did not appear to be any other factor to account for the sudden and consistent improvement observed.
持续性非卧床腹膜透析失败的主要原因是腹膜或出口部位感染金黄色葡萄球菌。1989年至1992年期间，通过根除鼻腔和会阴携带菌、持续使用出口部位封闭敷料、改善患者更换敷料的无菌技术以及避免敷料受潮等措施，试图减少葡萄球菌感染。与干预前的3年期间相比，导管使用寿命显著延长（1年时拔除率分别为13%和28%，P<0.001），金黄色葡萄球菌所致腹膜炎发作次数减少。该研究未进行前瞻性对照，但似乎没有其他因素可以解释所观察到的突然且持续的改善情况。
