The Effect of Catheter Revision on Intractable Exit Site Infection in CAPD Patients.
- Author:
Tae Woo KIM
1
;
Jun Young DO
;
Sung Hyun LEE
;
Dong Un BAE
;
Kyu Hyang JO
;
Jong Won PARK
;
Kyung Woo YOON
Author Information
1. Divison of Nephrology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea. jydo@med.yu.ac.kr
- Publication Type:Original Article
- Keywords:
Exit-site infection;
Catheter revision;
CAPD
- MeSH:
Anti-Bacterial Agents;
Catheters*;
Follow-Up Studies;
Humans;
Incidence;
Kidney Failure, Chronic;
Penicillins;
Peritoneal Dialysis;
Peritoneal Dialysis, Continuous Ambulatory*;
Peritonitis;
Prevalence;
Pseudomonas aeruginosa;
Quinolones;
Renal Dialysis;
Renal Replacement Therapy;
Retrospective Studies;
Staphylococcus aureus
- From:Korean Journal of Nephrology
2004;23(5):753-762
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Continuous ambulatory peritoneal dialysis (CAPD) is an important method of renal replacement therapy in chronic renal failure, and reduction of dialysis-associated complication is essential to successful peritoneal dialysis. But catheter related infection is a major cause of catheter loss and transferring to hemodialysis. We use an unique catheter revision method for the treatment of intractable exit-site/tunnel infection in CAPD patients. METHODS: We reviewed 322 CAPD patients on the ESI/TI from May 1995 to January 2003 at Yeungnam University Hospital. Forty-four patients had exit-site infection more than one times. Prevalence of exit-site infection, kinds of causative micro- organism and results of catheter revision were analyzed retrospectively. RESULTS: Total follow-up was 5, 834 patient months. ESI occurred on 141 occasions in 44 patients out of 322 patients and cumulative incidence of ESI was 1 per 41.4 patient months. We started empiric antibiotic therapy with oral penicillinase- resistant penicillin and quinolones, thereafter adjusted antibiotics according to the results of culture and sensitivity. The most common organism responsible for ESI was Staphylococcus aureus (MSSA, 34.8%), followed by Pseudomonas aeruginosa (25.5%). Nineteen patients had to be treated with catheter revision to control intractable ESI/TI. With analysis of ten patients who showed relapsed ESI after catheter revision, 5 patients improved with antibiotic therapy and 3 patients improved with additional secondary revision, but remaining 2 patients showed removal of peritoneal catheter to treat combined peritonitis. CONCLUSION: Catheter revision technique can be regarded as an effective alternative method to treat intractable exit site/tunnel infection before removal of catheter in CAPD patients.
