Current epidemiology and practice patterns in prevention and treatment of PD-related infections in Poland

Periton Diyalizi İle ilişkili Peritonitlerin İrdelenmesi

Objective: In this study, it was aimed to determine the causative microorganisms isolated in peritonitis attacks in peritoneal dialysis (PD) patients in our hospital and methicilline resistance rate in Staphlococci. Material and methods: 194 patients in the peritoneal dialysis unit of XXXXl Training and Research Hospital, Nephrology Clinic, between January 2009 and 2020, were evaluated retrospectively in terms of peritonitis development, causative microorganisms and methicillin resistance in Stapylococci, which is the most common causative agent. Results: Peritonitis attack developed in 149 out of a total of 194 patients. The causative agent has been isolated in 91 (61%) of the patients who developed peritonitis. When we look at the order of frequency among all microorganisms isolated, methicillin-susceptible Staphylococci (MHS) 59 (44.02%), methicillin-resistant Staphylococci (MRS) 28 (20.89%), Escherichia coli 12 (8.95%), Streptococcus spp 12 (8.95%), Enterobacter spp 7 (5.22%), Pseudomonas spp 4 (2.98%), diphtheroid bacilli 4 (2.98%), Klebsiella spp 2 (1.49%), Acinetobacter spp 1 (0.07%), a total of 129 bacteria, including five fungi were detected. Methicillin resistance rate was 32.18% among Staphylococci, which was found to be the most common causative agent. Conclusion: There is a need for studies with large patient groups to show the agents of peritonitis and the change in the resistance profile these microorganisms. Key words: Peritoneal Dialysis, Peritonitis, Methicillin Resistance

Daily self-care practices influence exit-site condition in patients having peritoneal dialysis: A multicenter cross-sectional survey

AIMS

To investigate practice patterns in exit-site care and identify the risk factors for exit-site infection.

DESIGN

A quantitative cross-sectional design.

METHODS

Data were collected in 12 peritoneal dialysis (PD) centres in 2018. Daily exit-site care practice patterns and exit-site status of patients receiving PD were assessed through interviews and questionnaires.

RESULTS/FINDINGS

Most of the 1,204 patients adhered with the protocols about main aspects of exit-site care, such as cleansing agents selection, frequency of cleansing, catheter fixation, and following the catheter protective measures. However, their adherence levels on hand hygiene, mask wearing, observing exit site, examining secretion, and communicating with PD staff were rather low. Eighty-four patients' exit sites were evaluated as problematic exit site (PES). And 186 patients had catheter-related infection (CRI) history. After multivariable logistic regression analysis, diabetes (OR = 1.631), traction bleeding history (OR = 2.697), antibiotic agents use (OR = 2.460), compliance on mask wearing (OR = 0.794), and observing exit site (OR = 0.806) were influencing factors of CRI history. Traction bleeding history (OR = 2.436), CRI history (OR = 10.280), and effective communication (OR = 0.808) with PD staff were influencing factors for PES.

CONCLUSIONS

The adherence levels on different aspects of exit-site care were varied in patients having PD. Their self-care behaviours did correlate with the exit-site status.

IMPACT

The adherence level of patients' exit-site care practice needs attention of medical staff. Further studies about the optimal procedure in exit-site care were warranted.