ISPD Catheter-related Infection Recommendations: 2023 Update

Chow, Kai Ming; Li, Philip Kam-Tao; Cho, Yeoungjee; Abu‐Alfa, Ali K.; Bavanandan, Sunita; Brown, Edwina A.; Cullis, Brett; Edwards, Dawn; Éthier, Isabelle; Hurst, Helen; Ito, Yasuhiko; Morelle, Johann; Runnegar, Naomi; Saxena, Anjali; So, Simon Wai-Yin; Tian, Na; Johnson, David W.

doi:10.1177/08968608231172740

Cited by 60 publications

(63 citation statements)

References 138 publications

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“…36 ISPD guidelines recommend that prophylactic antibiotics should be administered immediately before catheter placement to prevent catheter-related infections. 32 In the present study, prophylactic antibiotics were administered in most cases. DM is widely recognised as a risk factor for post-surgical infections.…”

Section: Discussionmentioning

confidence: 93%

“…Although the 2023 ISPD guidelines for catheter-related infections have downgraded the recommendation, the guideline still recommended daily topical application of antibiotic cream or ointment to the catheter exit site. 32 However, an international, prospective, observational study found that daily topical application of antibiotic cream or ointment to the catheter exit site has not been implemented in Japan. 33 In fact, the Japanese PD guidelines suggest not applying mupirocin/gentamicin ointment to the exit sites of PD patients.…”

Section: Discussionmentioning

confidence: 99%

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A multi-institutional, observational study of outcomes after catheter placement for peritoneal dialysis in Japan

Sakurada,

Kojima,

Yamada

et al. 2023

Perit Dial Int

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Background: This multi-institutional, observational study examined whether the outcomes after peritoneal dialysis (PD) catheter placement in Japan meet the audit criteria of the International Society for Peritoneal Dialysis (ISPD) guideline and identified factors affecting technique survival and perioperative complications. Methods: Adult patients who underwent first PD catheter placement for end-stage kidney disease between April 2019 and March 2021 were followed until PD withdrawal, kidney transplantation, transfer to other facilities, death, 1 year after PD start or March 2022, whichever came first. Primary outcomes were time to catheter patency failure and technique failure, and perioperative infectious complications within 30 days of catheter placement. Secondary outcomes were perioperative complications. Appropriate statistical analyses were performed to identify factors associated with the outcomes of interest. Results: Of the total 409 patients, 8 who underwent the embedded catheter technique did not have externalised catheters. Of the 401 remaining patients, catheter patency failure occurred in 25 (6.2%). Technical failure at 12 months after PD catheter placement calculated from cumulative incidence function was 15.3%. On Cox proportional hazards model analysis, serum albumin (hazard ratio (HR) 0.44; 95% confidence interval (CI) 0.27–0.70) and straight type catheter (HR 2.14; 95% CI 1.24–3.69) were the independent risk factors for technique failure. On logistic regression analysis, diabetes mellitus was the only independent risk factor for perioperative infectious complications (odds ratio 2.70, 95% CI 1.30–5.58). The occurrence rate of perioperative complications generally met the audit criteria of the ISPD guidelines. Conclusion: PD catheter placement in Japan was proven to be safe and appropriate.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

A multi-institutional, observational study of outcomes after catheter placement for peritoneal dialysis in Japan

Sakurada,

Kojima,

Yamada

et al. 2023

Perit Dial Int

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“…1. clinical features consistent with peritonitis (i.e., abdominal pain and/or cloudy dialysis effluent); 2. dialysis effluent white cell count .100/ml or .0.1310 9 /L (after a dwell time of at least 2 hours), with .50% polymorphonuclear leukocytes; and 3. positive dialysis effluent culture.…”

Section: Definitionsmentioning

confidence: 99%

Peritoneal Dialysis–Related Infections

Cho

Chow

et al. 2023

CJASN

Self Cite

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Peritoneal dialysis represents an important treatment choice for patients with kidney failure. It allows them to dialyze outside the hospital setting, facilitating enhanced opportunities to participate in life-related activities, flexibility in schedules, time and cost savings from reduced travel to dialysis centers, and improved quality of life. Despite its numerous advantages, the peritoneal dialysis utilization has been static or diminishing in parts of the world. Peritoneal dialysis-related infections, such as peritonitis, exit-site infection or tunnel infection, is a major concern for patients, caregivers, and health professionals – which may result in hesitation to consider this as treatment or to cease therapy when these complications take place. In this review, the definition, epidemiology, risk factors, prevention, and treatment of peritoneal dialysis-related infection based on the contemporary evidence will be described.

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“…We commend Chow et al on publishing these International Society for Peritoneal Dialysis (ISPD) Guidelines on PD Catheter-related Infections, a welcome update to the 2017 Guidelines. 1 These updated Guidelines have modified definitions of tunnel infection, made recommendations regarding cause-specific catheter-related infection, set a new target for exit-site infection rate and discuss suggestions about the need for an exit-site dressing cover.…”

mentioning

confidence: 99%