Risk factors and outcome of contamination in patients on peritoneal dialysis--a single-center experience of 15 years.
OBJECTIVE
Contamination is an important risk factor for peritoneal dialysis (PD)-related peritonitis. The present study outlines the clinical characteristics and outcomes of PD patients experiencing touch contamination.


METHODS
We reviewed the case records of PD patients from 1995 to 2010. Patients who experienced contamination of their PD system were identified and stratified into "dry" and "wet" contamination groups. Risk factors, microbiology, and clinical outcomes were compared.


RESULTS
Of 548 episodes of touch contamination, 246 involved dry contamination, and 302, wet contamination. After contamination, 17 episodes of peritonitis (3.1%) developed; all episodes occurred in the wet contamination group (p < 0.001). The incidence of peritonitis after wet contamination was 5.63%. Prophylactic antibiotics significantly reduced the risk of peritonitis (1 of 182 episodes, p < 0.001). Half the patients experiencing peritonitis had either culture-negative or staphylococcal episodes, and most of those episodes responded to intraperitoneal antibiotics. In 2 patients, peritonitis was attributable to Pseudomonas, and in 3, to Acinetobacter. In these latter patients, outcomes were less favorable, with catheter removal being required in 4 of the 5 episodes.


CONCLUSIONS
The overall rate of peritonitis was low after contamination. Wet contamination was associated with a much higher risk of peritonitis. Prophylactic antibiotics after wet contamination were effective in preventing peritonitis.
Renal Unit, Department of Medicine, Tung Wah Hospital, Hong Kong SAR, PR China. h9804155@hotmail.com
Desmond Y H
DY
Yap
Wai Ling
WL
Chu
Flora
F
Ng
Terence Pok Siu
TP
Yip
Sing Leung
SL
Lui
Wai Kei
WK
Lo
D000368:Aged; D019072:Antibiotic Prophylaxis; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors