Prevention of haemodialysis and peritoneal dialysis catheter related infection by topical povidone-iodine.

Catheter related sepsis, especially with staphylococci, is one of the most important complications of haemodialysis or peritoneal dialysis. In a prospective, randomized, open study of 129 haemodialysis patients, exit site infection and bacteraemia were significantly greater in the untreated group (18.2% each) than the group treated with povidone-iodine (PVP-I) ointment (4.8% each), P < 0.02. In nasal carriers of S. aureus, PVP-I resulted in 100% risk reduction of bacteraemia and exit site infection (P < 0.05) and 70% risk reduction of catheter tip infections (P < 0.05). Preliminary results of an on-going randomized study in patients on intermittent peritoneal dialysis suggest, in the 69 patients so far studied, a reduced S. aureus infection rate in patients who received PVP-I ointment at the catheter exit site (2.9%) compared with the untreated group (8.8%) despite a higher nasal carriage rate in the PVP-I group. Statistical significance has not been demonstrated for these interim results and the study is continuing.