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.
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http://dx.doi.org/10.1111/jan.14751 | DOI Listing |
Ther Apher Dial
January 2025
Department of Internal Medicine, Division of Nephrology, Marmara University School of Medicine, Istanbul, Turkey.
Introduction And Aim: Peritonitis is a critical complication in peritoneal dialysis (PD) patients, making compliance with personal hygiene essential. This study examines the impact of the COVID-19 (Coronavirus Disease 2019) pandemic on hygiene behaviors and peritonitis incidence in PD patients.
Materials And Methods: Fifty-two PD patients were assessed for hygiene behaviors, demographic, and medical data.
J Vasc Access
January 2025
College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Background: Hemodialysis vascular access predisposes patients to exit-site infections (ESIs) and bloodstream infections (BSIs), resulting in significant morbidity and mortality. The objective was to characterize hemodialysis catheter-related (CR) ESIs and BSIs while considering potential factors associated with infection.
Methods: The study period was selected to coincide with new CR-infection prevention measures at the midpoint.
Cureus
December 2024
Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, THA.
Infectious complications in peritoneal dialysis (PD) remain a constant challenge, with atypical pathogens posing significant risks. This case from Thailand highlights the rare occurrence of , an often-overlooked non-tuberculous mycobacterium (NTM), as the causative agent in a catheter-related exit-site infection that progressed to peritonitis. Initially misattributed to from preceding exit-site infections, was ultimately identified as the primary pathogen through multiple effluent cultures and advance polymerase chain reaction sequencing.
View Article and Find Full Text PDFDiseases
November 2024
Medical Microbiology and Immunology Unit, Department of Pathology, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia.
Dialysis-associated events such as bloodstream infections represent serious complications for hemodialysis patients, with the potential to increase morbidity and mortality. To assess the impact of implementing a comprehensive bundle of evidence-based practice on reducing dialysis event rates among catheter dialysis patients at Prince Mansour Military Hospital Dialysis Center. The study enrolled 111 hemodialysis participants.
View Article and Find Full Text PDFJ Vasc Access
December 2024
St. Joseph's Regional Medical Center, Paterson, NJ, USA.
Background: The decision to place a subcutaneously tunneled catheter is an infection prevention strategy for long term venous access allowing the proceduralist to access a vein and relocate the catheter exit site to a region on the body where care and maintenance can be safely performed. Subcutaneously tunneled centrally inserted dialysis catheter (ST-CIDC) placement is commonly performed in patients with renal disease and is traditionally performed with fluoroscopy in the interventional radiology suite or the operating theater. However, today's interventional radiologists and surgeons perform advanced invasive procedures that can be time-consuming resulting in delays in the scheduling of elective tunneled catheter placements.
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