ISPD Catheter-related Infection Recommendations: 2023 Update

Area of Science:

• Nephrology
• Infectious Diseases
• Medical Device Management

Background:

• Peritoneal dialysis (PD) catheter-related infections are significant causes of catheter loss and peritonitis.
• Clear definitions and classifications of infections are crucial for effective management.

Purpose of the Study:

• To summarize the 2023 updated recommendations for managing PD catheter-related infections.
• To highlight revised definitions, new targets, and updated treatment strategies.

Main Methods:

• Review and synthesis of the 2023 updated international recommendations for PD catheter infection management.
• Analysis of revised definitions for exit site infection (ESI) and tunnel infection (TI).

Main Results:

• A new target for overall ESI rate is set at ≤0.40 episodes per year at risk.
• Recommendations for topical antibiotic use at the exit site have been downgraded.
• Clarified guidance on exit site dressing and updated antibiotic treatment durations with emphasis on clinical monitoring.

Conclusions:

• The updated recommendations provide clearer definitions and management strategies for PD catheter infections.
• Emphasis is placed on achieving lower infection rates and optimizing antibiotic therapy.
• Catheter interventions such as cuff removal or relocation are now suggested alongside traditional approaches.