Staphylococcal Peritonitis in Continuous Ambulatory Peritoneal Dialysis: Colonization With Identical Strains at Exit Site, Nose, and Hands

Amato, Dante; Ventura, María de Jesús; Miranda, Guadalupe; Leaños, Blanca; Alcántara, Guadalupe; Hurtado, María Elena; Paniagua, Ramón

doi:10.1053/ajkd.2001.20576

Cited by 43 publications

(29 citation statements)

References 27 publications

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“…The benefit of prophylaxis not withstanding, answers to the questions of whether prophylaxis should be provided to all pediatric patients versus only those patients/parents who are determined to be carriers by screening, and whether the preferred agent should be mupirocin or gentamicin requires further study [27,33,34]. Although Hoshii et al recently reported on the development of S. aureus exit-site and tunnel infections in a population of pediatric PD patients despite the prophylactic use of mupirocin [35], the patients infrequent use of the agent and their preferential application of it intranasally vs. adjacent to the exit-site may have had a negative impact on the rate of the infectious complications [36]. Peritoneal dialysis training has previously been shown to play an essential role in disease prevention [2].…”

Section: Discussionmentioning

confidence: 99%

Prevention of peritonitis in children receiving peritoneal dialysis

et al. 2007

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Peritonitis and catheter-related (exit-site/tunnel) infections are major causes of morbidity in children receiving peritoneal dialysis (PD). Our objective was to evaluate the impact of a combination of prophylactic measures on the rate of peritonitis and catheter-related infections subsequent to their implementation in 2001. This is a single center review of incident patients who received automated peritoneal dialysis (APD) from 1997 to 2004. The causal microorganisms, annualized peritonitis and catheter-related infections rates and the time to infection were reviewed using pooled data from 1997 to 2000 and from 2001 to 2004. Fifty-four patients received PD over 1099 patient months (pm). Twenty-eight peritonitis episodes occurred in 15 patients over 599 pm from 1997 to 2000 (annualized rate (AR): 0.56 infections/patient year). Eight episodes of peritonitis occurred in five patients over 500 pm from 2001 to 2004 (AR: 0.19 infections/patient year) (P = 0.01). Prior to 2001, the median time from dialysis initiation to the first peritonitis episode was 500 days (95% CI, 400-660 days), compared to 1137 days (95% CI, 1050 to +Infinity) from 2001 to 2004 (P = 0.008). The rate of catheter-related infections and time to initial infection during the two periods was not different. We conclude that measures to decrease the frequency of peritonitis can be successfully applied to children and should be incorporated as part of standard care.

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Section: Discussionmentioning

confidence: 99%

Prevention of peritonitis in children receiving peritoneal dialysis

et al. 2007

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“…Antibiotic protocols against S. aureus are effective in reducing the risk of S. aureus catheter infections (66)(67)(68)(69)(70)(71)(72)(73)(74)(75)(76)(77)(78)(79)(80)(81) Routine exit-site care by the patient begins when the exit site is well healed; such care is part of the patient's training. Water and antibacterial soap are recommended by many centers.…”

Section: Exit-site Care To Prevent Peritonitismentioning

confidence: 99%

ISPD Position Statement on Reducing the Risks of Peritoneal Dialysis–Related Infections

et al. 2011

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“…However, as indicated in the 2010 update of the adult PD-related infections recommendations, the benefit of screening for S. aureus carriage, either after a staphylococcal peritonitis episode or routinely in the PD program, needs to be clarified (7). Approximately one half of PD patients have been found to be S. aureus nasal carriers, but the catheter exit site (rather than the nose and the nails) has also been shown to possibly be the most frequent site for colonization with S. aureus strains identical to those causing peritonitis (80,81). Screening for exit-site rather than nasal colonization may therefore be more advisable, although this practice is not routinely recommended at the present time.…”

Section: Guideline 42mentioning

confidence: 99%