Audit of infection in continuous ambulatory peritoneal dialysis.
The major cause of failure of continuous ambulatory peritoneal dialysis is peritoneal or exit site infection with Staphylococcus aureus. From 1989-1992, eradication of nasal and perineal carriage, continued use of an occlusive dressing to the exit site, improved aseptic technique for dressing changes by the patient and avoidance of wetting of the dressing were used in an attempt to reduce staphylococcal infections. By comparison with the 3-year period prior to intervention, a significant increase in the life of the catheters was achieved (removed at 1 year, 13 vs. 28%, P < 0.001) with a reduction in episodes of peritonitis due to S. aureus. The study was not prospectively controlled but there did not appear to be any other factor to account for the sudden and consistent improvement observed.
Wilson
A P
AP
Department of Clinical Microbiology, University College Hospital, London, UK.
Scott
G M
GM
Lewis
C
C
Neild
G
G
Rudge
C
C
D002404:Catheterization / Q000295:instrumentation; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008131:London; D008297:Male; D008485:Medical Audit; D009779:Occlusive Dressings; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010538:Peritonitis / Q000382:microbiology / Q000517:prevention & control*; D013203:Staphylococcal Infections / Q000382:microbiology / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013997:Time Factors