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Catheter-related Infections and Microbiological Characteristics in Coiled Versus Straight Peritoneal Dialysis
Anna M Abdul Rashid1, Christopher T S Lim2
1Internal Medicine Physician, Department of Medicine, Level 3, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
Background:
Catheter-related infections remain a threat in peritoneal dialysis (PD) patients. Attempts to improve catheter insertion techniques and catheter type with best infectious outcomes yield heterogenous results. We seek to determine catheter-related infections in two different types of catheters and its microbiological spectrum.
Methods:
Retrospective cross-sectional study conducted in Hospital Serdang, Malaysia. We included end-stage renal disease (ESRD) patients who opted for PD and examined catheter-related infections (peritonitis, exit site infection, and tunnel tract infection) and organisms causing these infections.
Results:
We included 126 patients in this study; 75 patients received the coiled PD catheter (59.5%) and 51 patients received the straight PD catheter (40.5%). The majority of patients were young, under the age of 65 years old (77.3% and 72.5%) in the coiled and straight PD catheter group, respectively, and the main cause of ESRD was diabetes mellitus in both groups (78.7% vs. 92.2%). The demographic and anthropometric data were similar between both groups. Peritonitis rate (0.29 episodes/patient-years vs. 0.31 episodes/patient-years, P value = 0.909), exit site infection rate (0.31 episodes/patient-year vs. 0.37 episodes/patient-year, P value = 0.730), and tunnel tract infection rate (0.02 episodes/patient-year, P value = 0.430) were similar in the coiled versus straight PD catheter groups. The predominant organism causing peritonitis was the gram-negative organism; Escherichia coli and Klebsiella pneumoniae. In exit site and tunnel tract infections, there is a predominance of gram-negative organisms; Pseudomonas aeruginosa and K. pneumoniae.
Conclusions:
There was no difference in infectious outcomes between the two different types of catheters. Type of organism in both groups was gram-negative.
Insights
Catheter-related infections in peritoneal dialysis (PD) patients were similar between coiled and straight PD catheters. Gram-negative organisms were the predominant cause of infections in both catheter types.
Area of Science:
- Nephrology
- Infectious Diseases
- Medical Devices
Background:
- Catheter-related infections (CRIs) pose a significant risk to patients undergoing peritoneal dialysis (PD).
- Despite advancements in catheter insertion and design, heterogeneous outcomes in preventing CRIs persist.
- This study investigates CRIs in PD patients comparing two distinct catheter types.
Purpose of the Study:
- To compare catheter-related infections, including peritonitis, exit site infections, and tunnel tract infections, between coiled and straight PD catheters.
- To identify the microbiological spectrum of infections associated with each catheter type.
Main Methods:
- A retrospective cross-sectional study was conducted at Hospital Serdang, Malaysia.
- End-stage renal disease (ESRD) patients on PD were included, examining infection rates and causative organisms.
- Data from 126 patients (75 coiled, 51 straight PD catheters) were analyzed.
Main Results:
- No significant differences were observed in peritonitis rates (0.29 vs. 0.31 episodes/patient-year), exit site infection rates (0.31 vs. 0.37 episodes/patient-year), or tunnel tract infection rates (0.02 episodes/patient-year) between coiled and straight PD catheters.
- Demographic and anthropometric data were similar between the groups.
- Gram-negative organisms, including *Escherichia coli*, *Klebsiella pneumoniae*, and *Pseudomonas aeruginosa*, were the predominant pathogens for all types of infections.
Conclusions:
- The type of PD catheter (coiled vs. straight) did not influence the incidence of catheter-related infections.
- Gram-negative bacteria are the primary causative agents for infections in PD patients, irrespective of catheter design.
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