Peritoneal Dialysis Exit-Site Care Protocols in Portugal and Its Association with Catheter-Related Infections.

Autor: Ferreira AC; Nephrology Department - Hospital de Curry Cabral, Centro Hospitalar e Universitário de Lisboa Central, Lisbon, Portugal.; Nova Medical School, Nova University of Lisbon, Lisbon, Portugal., Fernandes V; Nephrology Department - Hospital de Curry Cabral, Centro Hospitalar e Universitário de Lisboa Central, Lisbon, Portugal., Rodrigues A; Nephrology Department - Hospital de Santo António, Centro Hospitalar e Universitário do Porto, Oporto, Portugal., Abreu CP; Nephrology and Renal Transplant Department - Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte, Lisbon, Portugal., Pereira M; Nephrology and Renal Transplant Department - Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte, Lisbon, Portugal., Guedes AM; Nephrology Department - Centro Hospitalar e Universitário do Algarve, Faro, Portugal., Gomes AM; Nephrology Department - Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal., Cabrita A; Nephrology Department - Hospital de Santo António, Centro Hospitalar e Universitário do Porto, Oporto, Portugal., Soares C; Nephrology Department - Hospital de Braga, Braga, Portugal., Pego C; Nephrology Department - Hospital de São Teotónio, Centro Hospitalar de Tondela Viseu, Viseu, Portugal., Ferrer F; Nephrology Department - Centro Hospitalar do Médio Tejo, Torres Novas, Portugal., Bernardo I; Nephrology Department - Centro Hospitalar e Universitário do Algarve, Faro, Portugal., Fernandes JC; Nephrology Department - Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal., Assunção J; Nephrology Department - Centro Hospitalar Setúbal, Setúbal, Portugal., Oliveira L; Nephrology Department - Hospital de São Pedro de Vila Real, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal., Amoedo M; Nephrology Department - Hospital do Espírito Santo, Évora, Portugal., Carvalho MJ; Nephrology Department - Hospital de Santo António, Centro Hospitalar e Universitário do Porto, Oporto, Portugal., Branco P; Nephrology Department - Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Portugal., Maia P; Nephrology Department - Hospital Universitário de Coimbra, Coimbra, Portugal., Chorão R; Nephrology Department - Unidade de Saúde Local de Castelo Branco, Vila Real, Portugal., Castro R; Nephrology Department - Unidade de Saúde Local de Castelo Branco, Vila Real, Portugal., Silva R; Nephrology Department - Hospital de São Pedro de Vila Real, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal., Sousa T; Nephrology Department - Hospital de São Teotónio, Centro Hospitalar de Tondela Viseu, Viseu, Portugal., Mendes T; Nephrology Department - Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Carnaxide, Portugal.
Jazyk: angličtina
Zdroj: Blood purification [Blood Purif] 2023; Vol. 52 (4), pp. 366-372. Date of Electronic Publication: 2023 Jan 26.
DOI: 10.1159/000528641
Abstrakt: Introduction: Exit-site infection (ESi) prevention is a key factor in lowering the risk of peritonitis. This study aimed to evaluate the associations between exit-site (ES) care protocols and the annual incidence rates of ESi and peritonitis in Portugal.
Methods: We performed a national survey using two questionnaires: one about the incidence of catheter-related infections and the other characterizing patients' education and ES care protocols.
Results: In 2017 and 2018, 14 Portuguese units followed 764 and 689 patients. ESi incidence rate was 0.41 episodes/year, and the peritonitis incidence rate was 0.37. All units monitor catheter-related infections on a yearly basis, use antibiotic prophylaxis at the time of catheter placement, and treat nasal carriage of S. aureus, although with different approaches. Screening for nasal carriage of S. aureus is performed by 12 units, and daily topical antibiotic cream is recommended by 6 out of 14 of the units. We did not find statistical differences in ESi/peritonitis, comparing these practices. The rate of ESis was lower with nonocclusive dressing immediately after catheter insertion, bathing without ES dressing, with the use of colostomy bags in beach baths and was higher with the use of bath sponge. The peritonitis rate was lower with bathing without ES dressing and if shaving of the external cuff was performed in the presence of chronic ESi.
Conclusions: We found potential proceedings associated with ESi and peritonitis. A regular national audit of peritoneal dialysis units is an important tool for clarifying the best procedures for reduction of catheter-related infections.
(© 2023 S. Karger AG, Basel.)
Databáze: MEDLINE
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