title: Structural changes in silicon rubber peritoneal dialysis catheters in patients using mupirocin at the exit site.
abstract: Structural damage to polyurethane PD (peritoneal dialysis) catheters in patients using mupirocin ointment is widely appreciated, but damage to silicon rubber PD catheters is less well described. Ten catheters (6.6%) out of 152 were found to have structural alterations such as opacification, ballooning, thinning, and rupture. The duration of PD in these 10 patients ranged from 23 months to 80 months (mean duration 51.1 months). The frequency of mupirocin application varied from daily (2 cases) to 2-3 times per week (7 cases). In eight catheters opacification occurred at the exit site whereas one catheter showed opacification midway between the exit site and the titanium adaptor. One catheter showed opacification, ballooning, and thinning at the exit site ruptured in the form of two slit-like openings. In conclusion, various structural changes such as opacification, ballooning or thinning were seen in 6.6% of silicon rubber PD catheters in patients using mupirocin at the exit site. Although the mechanism remains elusive, mupirocin or the antiseptic solution alone or in combination may be contributory. We believe that this is an under-reported complication and encourage other health care givers to incorporate a search for such changes during clinic visits.
authors.affiliation: Division of Nephrology, University Health Network, University of Toronto, Toronto, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Khandelwal
authors.forename: S
authors.initials: S
authors.lastname: Bailey
authors.forename: S
authors.initials: S
authors.lastname: Izatt
authors.forename: M
authors.initials: M
authors.lastname: Chu
authors.forename: S
authors.initials: S
authors.lastname: Vas
authors.forename: J
authors.initials: J
authors.lastname: Bargman
authors.forename: D
authors.initials: D
authors.lastname: Oreopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D002404:Catheterization; D005260:Female; D006801:Humans; D008297:Male; D008422:Materials Testing; D008875:Middle Aged; D016712:Mupirocin / Q000009:adverse effects*; D010530:Peritoneal Dialysis; D012826:Silicone Elastomers
chemical_list: D000900:Anti-Bacterial Agents; D012826:Silicone Elastomers; D016712:Mupirocin