Continuous ambulatory peritoneal dialysis (CAPD) is a renal replacement therapy of choice in small children, the elderly, diabetics, subjects with cardiovascular disease and with difficulties in vascular access. Frequent complication of this method is the infection of the Tenckhoff catheter exit site, definition of which has not been firmly established yet. The aim of this study was to assess the frequency of catheter exit infections, its bacterial etiology and the efficacy of antibiotic treatment. The study material consisted of 21 subjects (11 female, 10 male) treated with CAPD in 1992-99 at our department, mean age 19.8 +/- 11.8 yrs, with mean CAPD treatment time 33 +/- 27 months. They were divided into two groups: group I--patients aged > or = 5 yrs, and group II--patients aged 15 yrs. Mean catheter usage time was 15.8 +/- 14.9 months. 43 cases of catheter exit site infection was diagnosed (0.7 case of infection per patient per year). Infection frequency was found to be 1 case in 9.4 months and 1 in 26.5 months, in group I and II, respectively (p < 0.001). Catheter usage in two groups was 10.4 +/- 8.2 and 21.4 +/- 15.4 months, respectively (p < 0.01). The most frequent pathogen was S. aureus (31 cases), with 5 cases of MRSA strains found. Antibiotic treatment was applied according to Keane's recommendations and it lasted 13.2% of CAPD treatment duration. In conclusion, catheter exit site infection occurred more often in children under the age of 5 yrs, and the catheter usage time was significantly shorter in this group of patients.
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