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Background: A prospective cohort study was undertaken to compare the rates of the infecting microorganisms of the peritoneal catheter exit-site in three periods of the prophylactic protocol of a peritoneal dialysis program. All patients treated for more than one month on Peritoneal Dialysis were included: Fourty-eight in Period 1 (P1), 48 in Period 2 (P2), and 54 in Period 3 (P3). Each period was of 3 years. Methods: Infection prophylaxis protocol: P1: hydrogen peroxide or povidone iodine and non-occlusive dressing; P2: sterile water (boiled water) instead of antiseptic agents, semi-permeable dressing for taking showers, and nasal mupirocine prophylaxis for Staphylococcus aureus carriers; P3: equal to P2, plus local application of antibiotics in equivocal exit-site for infection and argentic nitrate in granulation tissue. Main outcome measure: The rates of catheter infection and microorganisms causing infection were analysed by means of the Poisson regression method. Chi-square and ANOVA when appropiate. Results: The proportion of catheters implanted by nephrologist or surgeon (p <0 01 and modality treatment by capd or ccpd p <0 0001 were significantly different in the three periods while staph aureus carrieres was limit of significance p throughout a decreasing rate total and acute infections <0 001 staph aureus p and peritonitis were found the pseudomonas aer gram negative bacteria decreased significantly in p2 multiple factor analysis included eight factors: sex age group esrd dm catheter implatation nephrologist surgeon modality treatment capd ccpd manufacturer prophylaxis period as possible predictors of infections specific microorganisms that revealed main predictive improvements <0 02 - p <0 001 in contrast the corynebacteria spp increased significantly p="0.039," throughout three periods one half of each period could be considered colonisers other caused true infections but not those episodes required catheter intervention non-diphtheria increase was found related with continuous cycling peritoneal dialysis treatment multiple factor analysis and proportion c2 conclusion: progressive protocol applied obtained good results without continued use local antiseptics or antibiotics at exit-site however sp infection increment favours consideration an antiseptic agent for care</0> </0> </0> </0> </0>" ] "es" => array:1 [ "resumen" => "Resúmen: Patrón microbiológico de la infección del cateter peritoneal: aumento de Corynebacterium sp.?. En un estudio de cohorte se observaron prospectivamente los gérmenes causantes de infección en el catéter peritoneal en tres protocolos de profilaxis consecutivos, de 3 años cada uno. Pacientes con más de un mes de permenencia en Diálisis Peritoneal: 48 en el período 1 (P1), 48 en el período 2 (P2) y 54 en el período 3 (P3). Métodos: La profilaxis de infección del catéter fue: P1: Peróxido de hidrógeno o Povidona yodada y apósito no oclusivo; P2: Agua estéril (hervida), apósito semipermeable para la ducha y mupirocina nasal para los portadores de Staf. aureus; P3: igual que en el período anterior añadiendo antibióticos locales para los orificios equivocos de infección y aplicación de nitrato de plata en el tejido de granulación. Análisis estadístico: regresión de Poisson, c2 y ANOVA. Resultados: A través de los 3 períodos hubo una disminución significativa de la tasa de infecciones totales (aguda, crónica y del manguito) (p=0.0035), agudas (p <0 001 las causadas por staph aureus p y también de peritonitis infecciones pseudomonas aer gérmenes gram negativos disinuyeron significativamente en el p2 análisis multifactorial confirmó período profilaxis como principal factor predictivo los cambios tasas infección microorganismos específicos entre <0 02 y <0 001 sin embargo las infecciones por corynebacterium sp aumentaron significativamente p="0.039)." a través de los tres períodos en el análisis factores este aumento se halló relacionado con tratamiento diálisis peritoneal contínua cíclica dpcc multifactorial y proporciones conclusión: protocolo profilaxis la infección del orificio catéter dp aplicado usar continuadamente antisépticos o antibióticos locales ha demostrado buenos resultados para mayoría microorganismos obliga considerar aplicación</0> </0> </0>" ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000002700000003/v0_201502091552/X2013251407021312/v0_201502091552/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/20132514/0000002700000003/v0_201502091552/X2013251407021312/v0_201502091552/en/P-E-S-A4535-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251407021312?idApp=UINPBA000064" ]
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The microbial pattern of the catheter exit-site infection in peritoneal dialysis: A non-diphteria Corynebacteria emergence?
Patrón microbiológico de la infección del cateter peritoneal: aumento de Corynebacterium sp.?
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Josep Teixidó Planas, Nieves Arias Suárez, Laura Tarrats Velasco, Ramón Romero González
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Summary: The microbial pattern of the catheter exit-site infection in peritoneal dialysis: A non-diphteria Corynebacteria emergence? Background: A prospective cohort study was undertaken to compare the rates of the infecting microorganisms of the peritoneal catheter exit-site in three periods of the prophylactic protocol of a peritoneal dialysis program. All patients treated for more than one month on Peritoneal Dialysis were included: Fourty-eight in Period 1 (P1), 48 in Period 2 (P2), and 54 in Period 3 (P3). Each period was of 3 years. Methods: Infection prophylaxis protocol: P1: hydrogen peroxide or povidone iodine and non-occlusive dressing; P2: sterile water (boiled water) instead of antiseptic agents, semi-permeable dressing for taking showers, and nasal mupirocine prophylaxis for Staphylococcus aureus carriers; P3: equal to P2, plus local application of antibiotics in equivocal exit-site for infection and argentic nitrate in granulation tissue. Main outcome measure: The rates of catheter infection and microorganisms causing infection were analysed by means of the Poisson regression method. Chi-square and ANOVA when appropiate. Results: The proportion of catheters implanted by nephrologist or surgeon (p <0 01 and modality treatment by capd or ccpd p <0 0001 were significantly different in the three periods while staph aureus carrieres was limit of significance p throughout a decreasing rate total and acute infections <0 001 staph aureus p and peritonitis were found the pseudomonas aer gram negative bacteria decreased significantly in p2 multiple factor analysis included eight factors: sex age group esrd dm catheter implatation nephrologist surgeon modality treatment capd ccpd manufacturer prophylaxis period as possible predictors of infections specific microorganisms that revealed main predictive improvements <0 02 - p <0 001 in contrast the corynebacteria spp increased significantly p="0.039," throughout three periods one half of each period could be considered colonisers other caused true infections but not those episodes required catheter intervention non-diphtheria increase was found related with continuous cycling peritoneal dialysis treatment multiple factor analysis and proportion c2 conclusion: progressive protocol applied obtained good results without continued use local antiseptics or antibiotics at exit-site however sp infection increment favours consideration an antiseptic agent for care0> 0> 0> 0> 0>
Keywords:
peritoneal dialysis catheter infection, prophylaxis, microorganisms, Corynebacterium
Resúmen: Patrón microbiológico de la infección del cateter peritoneal: aumento de Corynebacterium sp.?. En un estudio de cohorte se observaron prospectivamente los gérmenes causantes de infección en el catéter peritoneal en tres protocolos de profilaxis consecutivos, de 3 años cada uno. Pacientes con más de un mes de permenencia en Diálisis Peritoneal: 48 en el período 1 (P1), 48 en el período 2 (P2) y 54 en el período 3 (P3). Métodos: La profilaxis de infección del catéter fue: P1: Peróxido de hidrógeno o Povidona yodada y apósito no oclusivo; P2: Agua estéril (hervida), apósito semipermeable para la ducha y mupirocina nasal para los portadores de Staf. aureus; P3: igual que en el período anterior añadiendo antibióticos locales para los orificios equivocos de infección y aplicación de nitrato de plata en el tejido de granulación. Análisis estadístico: regresión de Poisson, c2 y ANOVA. Resultados: A través de los 3 períodos hubo una disminución significativa de la tasa de infecciones totales (aguda, crónica y del manguito) (p=0.0035), agudas (p <0 001 las causadas por staph aureus p y también de peritonitis infecciones pseudomonas aer gérmenes gram negativos disinuyeron significativamente en el p2 análisis multifactorial confirmó período profilaxis como principal factor predictivo los cambios tasas infección microorganismos específicos entre <0 02 y <0 001 sin embargo las infecciones por corynebacterium sp aumentaron significativamente p="0.039)." a través de los tres períodos en el análisis factores este aumento se halló relacionado con tratamiento diálisis peritoneal contínua cíclica dpcc multifactorial y proporciones conclusión: protocolo profilaxis la infección del orificio catéter dp aplicado usar continuadamente antisépticos o antibióticos locales ha demostrado buenos resultados para mayoría microorganismos obliga considerar aplicación0> 0> 0>
Palabras clave:
Infección del catéter peritoneal, profilaxis, diálisis peritoneal, microorganismos, Corynebacterium
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