CAPD disconnect systems: UK peritonitis experience

We reviewed peritonitis (P) experience of four UK units using single use Y (Freeline T.M., Baxter UK)(F) and Twinbag (Solo T.M., Baxter UK) (S) disconnect systems, which incorporate the 'Flush Before Fill' principle. We aim to show clinical achievements, in varying circumstances, in the light of previously published in vitro study results. Each unit recorded P data, i.e., rates, causative organisms, and recurrences (R) over a 12 month period (Sept 89-Aug 90). This data was then analysed by system, by unit and in total. Each unit had similar definitions for P and R, but had varying system selection criteria. Unit 1 had a fairly open criteria for F use, then became more selective at the same time as introducing S. In unit 2, F, and then S, were first choice systems for all (inc. blind diabetics). Unit 3 trains every pt. on non-disconnect System 2, then pt. choice determines if they are retained onto a disconnect system. Unit 4 had a more highly selected population. Results, expressed as episodes/patient month, were as follows: [table: see text] We conclude that it is possible to achieve a low incidence of P, especially that caused by S. epidermidis, particularly with S. It would seem the extent is related to pt. to system selection criteria. The effects of R and ES/TI need to be addressed.