Sixty-one new
continuous ambulatory peritoneal dialysis (
CAPD) patients were allocated to a Y connector-
disinfectant (
Amuchina, Italy) and 63 to standard systems (Baxter Systems II & III) in a randomized clinical trial addressing
peritonitis rates in 8
CAPD programs in 6 Canadian cities. In the Y connector-
disinfectant group, 15 patients experienced 21 episodes of
peritonitis in 452 15 patients experienced 21 episodes of
peritonitis in 452 patient-months or 1 per 21.53 patient-months. In the standard systems group, 30 patients experienced 47 episodes of
peritonitis in 467 patient-months or 1 per 9.93 patient-months (p = 0.009). The
peritonitis risk reduction was 61% (95% confidence limits 27-79%). Exit-site
infections occurred in 36% of each group. Prior to the development of exit-site
infection, the monthly risk for
peritonitis was 3.12% for the Y connector
disinfectant system and 7.37% for the standard system. After an exit-site
infection, these probabilities increased to 6.15% and 15.47%, respectively. Skin organisms were responsible for
peritonitis in 8/21 (38%) in the Y connector-
disinfectant group and 30/47 (64%) in the standard group. There were 75 days hospitalized for
peritonitis in the Y connector-
disinfectant group compared to 257 days for the standard group. The Y connector
disinfectant system decreases the
peritonitis rate through its effect on skin organisms. Exit-site
injections are a major source of organisms responsible for
peritonitis.