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Prevention of catheter related infections in patients on CAPD.

Abstract
Catheter-related infections remain a serious problem for patients on peritoneal dialysis. Such infections can be reduced by careful patient selection and training, by the use of the best connection technology and screening and treating nasal carriage. To date, treatment is less than optimal and therefore, the primary goal should be prevention of catheter-related infections. Prevention is based on improving catheter design and implantation technique, while providing careful exit-site care. Regardless of how it is implemented, we must aggressively pursue the prevention of catheter-related infections by eradicating S. aureus exit-site carriage in PD patients. Based on its effectiveness in adult PD patients, its low rate of adverse effects, and its reasonable cost-effectiveness, application of mupirocin ointment at the exit-site is the current method of choice for preventing PD catheter infections caused by S. aureus. In addition to reducing S. aureus exit-site infections, mupirocin seems to reduce the rates of staphylococcal peritonitis and PD catheter loss. Whether the ointment should be applied in the nares, to the exit-site or both, and whether it should be used only in staphylococcal nasal carriers or all PD patients requires further study.
AuthorsE Thodis, P Passadakis, V Vargemezis, D G Oreopoulos
JournalThe International journal of artificial organs (Int J Artif Organs) Vol. 24 Issue 10 Pg. 671-82 (Oct 2001) ISSN: 0391-3988 [Print] United States
PMID11817317 (Publication Type: Journal Article, Review)
Chemical References
  • Anti-Bacterial Agents
  • Mupirocin
Topics
  • Anti-Bacterial Agents (therapeutic use)
  • Antibiotic Prophylaxis
  • Catheters, Indwelling (adverse effects)
  • Equipment Design
  • Humans
  • Infections (etiology)
  • Mupirocin (therapeutic use)
  • Peritoneal Dialysis, Continuous Ambulatory (adverse effects)
  • Primary Prevention (methods)
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Staphylococcal Infections (etiology, microbiology, prevention & control)
  • Staphylococcus aureus
  • Treatment Outcome

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