The Triveneto Peritoneal Dialysis (PD) Network aims to bring together doctors and nurses who deal with PD in a collaborative network in which to exchange mutual knowledge and optimize the use of this method of replacing renal function. A topic of particular interest was the management of peritoneal catheter exit-site infection, given the recent publication of the new guidelines of the International Society of Peritoneal Dialysis (ISPD). The survey concerned the criteria for carrying out nasal swab and exit-site, management of exuberant granulation tissue "Proud Flesh", treatment of exit-site infection (ESI), use of silver dressings, the role of subcutaneous tunnel ultrasound and cuff shaving. All PD centers in the North-East Italy area have joined the survey with at least one operator per centre. There was a wide variability between the indications for performing the exit-site swab. In the presence of ESI, the prevalent approach is that of oral systemic empiric therapy associated (20.0%) or less (28.9%) with topical therapy, and then adapting it in a targeted manner to the culture examination. From the discussion of the survey emerged the importance of the ESI as an outcome indicator, which allows us to verify whether our clinical practice is in line with the reference standards. It is essential to know and base our activity on what is indicated in national and international guidelines and to document the events that occur in the patient population of each dialysis unit.
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Int Urol Nephrol
December 2024
Nephrology Dialysis and Kidney Transplant Unit, Azienda Ospedaliero - Universitaria di Modena, Via del Pozzo, 71, 41124, Modena, Italy.
Introduction: Screening for nasal carriage of Staphylococcus (S.) aureus is associated with a reduction of peritoneal dialysis (PD)-related infections, but conflicting results have questioned the benefit of this practice. This study evaluated the clinical effectiveness of the screening program for nasal carriage of S.
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.
View Article and Find Full Text PDFJ Artif Organs
December 2024
Departments of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita Shi, Osaka, Osaka fu, 565-0871, Japan.
Left ventricular assist devices (LVADs) are implanted in patients with heart failure to support cardiac circulation. However, no standardized methods have been established for LVAD driveline exit site management for the prevention of infections. Therefore, this study evaluated the efficacy of modified driveline management compared with that of conventional driveline management.
View Article and Find Full Text PDFTransplant Proc
December 2024
Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan. Electronic address:
Background: Driveline infections (DLI) caused by nontuberculous mycobacteria (NTM) in patients with implantable left ventricular assist devices (iLVAD) are rare but fatal, requiring early diagnosis and appropriate treatment. Herein, we present a rare case of DLI caused by Mycobacterium chelonae, which was promptly diagnosed using Gram stain and Ziehl-Neelsen stain and followed a favorable clinical course.
Case Presentation: A 51-year-old man with an iLVAD complicated by DLI was admitted to our center.
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