Med Bull Sisli Etfal Hosp. 2019; 53(4): 385-388 | DOI: 10.14744/SEMB.2019.54837

Comparison of Exit-Site Infection Frequency in Continuous Ambulatory Peritoneal Dialysis and Automated Peritoneal Dialysis Patients: A Single-Center Experience

Mustafa Sevinc¹, Nuri Baris Hasbal², Elbis Ahbap¹, Yener Koc^3
1Department of Nephrology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
²Department of Nephrology, Hakkari State Hospital, Hakkari, Turkey
³Department of Nephrology, Istanbul Bilim University Faculty of Medicine, Istanbul, Turkey

Objectives: Catheter exit-site infection (ESI) is generally caused by skin flora. Continuous ambulatory peritoneal dialysis (CAPD) patients have more contact with their catheters than automated peritoneal dialysis (APD) patients as a result of performing multiple exchanges per day. The aim of the present study was to compare the frequency of ESIs between these 2 peritoneal dialysis (PD) modalities.
Methods: PD patients from 2001 to 2015 were enrolled in the study. Patients transferred from CAPD to APD were excluded. All of the data were collected retrospectively. The rate of ESI occurrence and culture results in the CAPD and APD groups were compared.
Results: The data of 280 patients were evaluated. APD patients represented 23.2% of the study cohort. Prevalence of peritonitis was 87.6% if a patient had an ESI and 50.7% if there was no ESI (p=0.000). The frequency of ESI was similar between the 2 peritoneal dialysis modalities (p=0.343). There was a statistically significant difference in the causative organism of infection between the 2 groups (p=0.021).
Conclusion: The ESI rate was similar in the CAPD and APD patients though CAPD requires more exchanges, and therefore there is more contact with the catheter. All PD patients, regardless of the treatment modality used, are expected to perform exchanges according to standard rules for connecting the catheter to the PD solution bag. As long as patients observe these guidelines, there would appear to be no increased ESI risk related specifically to the modality.

Keywords: Automated peritoneal dialysis, continuous ambulatory peritoneal dialysis; exit-site infection; peritoneal dialysis.

---

Comparison of Exit-Site Infection Frequency in Continuous Ambulatory Peritoneal Dialysis and Automated Peritoneal Dialysis Patients: A Single-Center Experience

Mustafa Sevinc¹, Nuri Baris Hasbal², Elbis Ahbap¹, Yener Koc^3
11Department of Nephrology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
²Department of Nephrology, Hakkari State Hospital, Hakkari, Turkey
³Department of Nephrology, Istanbul Bilim University Faculty of Medicine, Istanbul, Turkey

Amaç: Kateter çýkýþ yeri enfeksiyonu genellikle cilt florasýndan kaynaklanýr. Sürekli ayaktan periton diyalizi hastalarý gün içinde daha çok deðiþim yaptýklarý için kateterle aletli periton diyalizi hastalarýna göre daha çok temas ederler. Bu çalýþmanýn amacý iki periton diyaliz modalitesi arasýnda kateter çýkýþ yeri enfeksiyon sýklýðýný karþýlaþtýrmaktýr.
Metot: 2001 ve 2015 yýllarý arasýndaki periton diyaliz hastalarý çalýþmaya dâhil edilmiþtir. Sürekli ayaktan periton diyalizinden aletli periton diyalizine transfer edilen hastalar çalýþma dýþý býrakýlmýþtýr. Tüm veriler geriye dönük olarak toplanmýþtýr. Periton diyalizi modaliteleri, çýkýþ yeri enfeksiyon sýklýðý ve kültür sonuçlarý açýsýndan birbiri ile karþýlaþtýrýlmýþtýr.
Bulgular: Toplam 280 hastanýn verisi incelenmiþtir. Aletli periton diyalizi hastalarý tüm grubun %23.2’sini oluþturmaktadýr. Çýkýþ yeri enfeksiyonu geçirenlerde peritonit riski %87.6, geçirmeyenlerde ise %50.7 saptanmýþtýr (p=0.000). Periton diyalizi modaliteleri arasýnda çýkýþ yeri enfeksiyon sýklýðý benzer bulunmuþtur (p=0.343). Üretilen mikroorganizmalarda ise farklýlýk saptanmýþtýr (p=0.021).
Sonuç: Çýkýþ yeri enfeksiyonu sýklýðý, sürekli ayaktan periton diyalizi ve aletli periton diyalizinde benzer bulunmuþtur. Sürekli ayaktan periton diyalizi daha fazla deðiþim yapar ve kateterle daha fazla temas ederler. Tüm hastalarýn deðiþim sýrasýnda periton kateterini diyaliz solüsyon torbasýna baðlarken önerilen kurallara uymasý beklenmektedir. Bu kurallar periton diyalizi modaliteleri arasýnda farklýlýk göstermez. Hastalar kurallara uyduðu sürece, periton diyalizi modalitesinden kaynaklanan enfeksiyon riskini artýþý söz konusu deðildir.

Anahtar Kelimeler: Aletli periton diyalizi, çýkýþ yeri enfeksiyonu, sürekli ayaktan periton diyalizi, periton diyalizi

---

CITE