Relationship between peritonitis and exit site infections in CAPD

Area of Science:

• Nephrology
• Infectious Diseases
• Clinical Medicine

Background:

• Peritonitis and exit site infections are common complications in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).
• Understanding the relationship between these infections is crucial for effective management and patient outcomes.

Purpose of the Study:

• To retrospectively review the treatment of CAPD-related exit site infections using oral ciprofloxacin and intraperitoneal vancomycin.
• To determine the relationship between exit site infections and peritonitis in CAPD patients.

Main Methods:

• Retrospective review of 48 CAPD patients with 172 infection episodes.
• Analysis of treatment outcomes for exit site infections with oral ciprofloxacin and intraperitoneal vancomycin.
• Assessment of the temporal relationship between peritonitis and exit site infections.

Main Results:

• Exit site infections occurred infrequently without peritonitis (23% of occasions).
• 37% of patients with initial peritonitis subsequently developed exit site infections, with a mean onset of 8.2 months.
• 44% of exit site infections showed treatment failure, with 67% being relapses or possible relapses. *Staphylococcus aureus* was the most common isolate.

Conclusions:

• The combination of oral ciprofloxacin and intraperitoneal vancomycin was associated with a high incidence of treatment failures for CAPD-related exit site infections.
• Peritonitis may precede and contribute to the development of exit site infections, necessitating careful monitoring and management.
• Further research is needed to optimize treatment strategies and improve outcomes for these infections.