The impact of exit-site care and catheter design on the incidence of catheter-related infections.
The optimal approach to catheter exit-site care and catheter design in terms of catheter-related infections (e.g., exit-site infections, peritonitis) in children remains elusive. We retrospectively compared the incidence of exit-site infections and peritonitis in 33 pediatric peritoneal dialysis patients who used one of three exit-site care/catheter combinations. The catheters used were single-cuffed, curled Tenckhoff (T), and double-cuffed Swan neck (SN). Exit-site care included either povidone-iodine (PI) or chlorhexidine (CHL) as cleansing agents. Our data suggest that the use of chlorhexidine versus povidone-iodine is associated with a significant decrease (p < 0.05) in the frequency of catheter exit-site infections in children. The use of the Swan-neck double-cuffed catheter does not appear to have any further impact on the frequency of exit-site infections. Neither the use of chlorhexidine nor Swan neck catheters had an effect on our peritonitis rate. Our review suggests that a prospective evaluation of a chlorhexidine-based exit-site care regimen in children should be encouraged.
Pediatric Dialysis Program, Children's Mercy Hospital, Kansas City, Missouri, USA.
L L
LL
Jones
L
L
Tweedy
B A
BA
Warady
D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D001424:Bacterial Infections / Q000209:etiology / Q000517:prevention & control*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002648:Child; D002710:Chlorhexidine / Q000008:administration & dosage; D004867:Equipment Design; D006801:Humans; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000295:instrumentation; D010538:Peritonitis / Q000209:etiology / Q000517:prevention & control*; D011206:Povidone-Iodine / Q000008:administration & dosage; D012189:Retrospective Studies
D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine; D002710:Chlorhexidine