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Catheter‐related infections in peritoneal dialysis patients: New aspects
Author(s) -
VYCHYTIL Andreas,
HÖRL Walter H
Publication year - 1998
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/j.1440-1797.1998.tb00366.x
Subject(s) - medicine , catheter , peritoneal dialysis , peritonitis , antibiotics , surgery , mupirocin , staphylococcus aureus , intensive care medicine , methicillin resistant staphylococcus aureus , genetics , bacteria , microbiology and biotechnology , biology
SUMMARY: Catheter‐related infections remain a major cause of technical dropout in peritoneal dialysis patients. Staphylococcus aureus (S. aureus) is the most important causative organism of these infections. the objective of this paper is to give an overview of recent developments in the prophylaxis and therapy of infectious catheter complications. It has been shown that prophylactic therapy, with mupirocin or rifampin, results in a decrease of catheter‐related infections. However, due to clinical problems associated with long‐term antibiotic therapy, prophylactic treatment should be restricted to patients at high risk of developing these infections, such as diabetic exit‐site carriers, immunosuppressed patients and non‐diabetic, non‐immunosuppressed patients with two or more S. aureus positive nasal cultures. the prognosis of catheter‐related infections depends on the respective organism and the extent of inflammation. Tunnel sonography is of major importance for early diagnosis of tunnel involvement and for estimating the outcome of tunnel infections. In patients with deep tunnel infection showing marked sonographic improvement two weeks after starting therapy, antibiotic treatment should be prolonged, whereas lack of sonographic improvement is associated with a high risk of catheter loss. In patients with tunnel infection and simultaneous peritonitis, catheter removal is recommended.