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Peritonitis secondary to dialysis tubing contamination among patients undergoing continuous ambulatory peritoneal
Abstract:
Patients were asked to report all dialysis system contaminations occurring from December 1985 through May 1988 to the home training facility. There were 74 instances of peritoneal dialysis system contamination, 20 of which resulted in peritonitis. Prophylactic antibiotics were used in 48 of 54 episodes not resulting in peritonitis. Three cultures yielded gram-positive organisms without clinical peritonitis becoming evident. Fourteen of the 20 episodes of peritonitis had received antibiotics prophylactically. System contaminations were classified into tears or holes of the catheter at the adapter on the Tenckhoff catheter or at the tubing connection to the dialysate bag and breaks of the connecting devices from either dialysis catheter to dialysis tubing or dialysis tubing to dialysate bag. System contaminations accounted for 20 of the 333 episodes of peritonitis that occurred during this time. Identifying system contamination is useful because prophylactic antibiotic therapy may prevent peritonitis.
Insights
Dialysis system contamination, including catheter or tubing breaks, can lead to peritonitis. Prophylactic antibiotics may help prevent peritonitis in patients undergoing peritoneal dialysis.
Area of Science:
- Nephrology
- Infectious Disease
Background:
- Peritoneal dialysis is a common treatment for kidney failure.
- System contamination during peritoneal dialysis can lead to serious infections like peritonitis.
Purpose of the Study:
- To identify the incidence and types of dialysis system contaminations.
- To assess the relationship between system contamination and peritonitis.
- To evaluate the effectiveness of prophylactic antibiotics in preventing peritonitis.
Main Methods:
- Retrospective review of patient-reported dialysis system contaminations from December 1985 to May 1988.
- Classification of contamination types (catheter tears, tubing connection breaks, etc.).
- Analysis of peritonitis episodes and prophylactic antibiotic use.
Main Results:
- 74 instances of peritoneal dialysis system contamination were reported.
- 20 of these contaminations resulted in peritonitis.
- System contaminations accounted for 20 out of 333 total peritonitis episodes.
- Prophylactic antibiotics were used in most non-peritonitis episodes and in 14 of 20 peritonitis episodes.
Conclusions:
- Identifying and addressing dialysis system contamination is crucial.
- Prophylactic antibiotic therapy shows potential in preventing peritonitis in peritoneal dialysis patients.
