Mr Jadon Ryan Yang1, Ms MARIA DARAOAY2, Associate Professor LUKAS KAIRAITIS1,2, Dr JOHN WING LI1,2, Associate Professor KAMAL SUD3,4, Dr KATRINA CHAU1,2
1School of Medicine, Western Sydney University , Campbelltown, Australia, 2Regional Dialysis Centre, Blacktown Hospital, Blacktown, Australia, 3Nepean Kidney Research Centre, Department of Renal Medicine, Nepean Hospital, Kingswood, Australia, 4Nepean Clinical School, Faculty of Medicine & Health, The University of Sydney, Kingswood, Australia
Biography:
Jadon is a 5th year medical student at Western Sydney University who has a special interest in nephrology.
Aim:
To assess the impact of exit-site care practices, including type of antiseptic use, on infection rates in patients on peritoneal dialysis (PD).
Background:
Catheter related infections (CRIs) can lead to severe complications such as peritonitis and catheter removal. Adherence to guidelines and its impact on infection rates remain unclear.
Methods:
A cross-sectional survey was conducted among prevalent PD patients at Western Renal Services during routine clinic visits. The local exit-site care policy recommends the use of povidone-iodine for the first 6-8 weeks, and either povidone-iodine or Medihoney thereafter. Participants provided information on exit-site care practices and adherence to training instructions. Clinical data on CRIs and peritonitis were retrieved from electronic medical records. Chi-square tests with Bonferroni correction were used to compare infection rates.
Results:
Fifty-six patients on PD were surveyed, with a mean dialysis vintage of 825 days (SD=775). Of these, 27 (48%) had diabetes and 12 (21%) had coronary artery disease (CAD). Thirty-three (59%) patients used povidone-iodine, 7 (12.5%) used Medihoney, 14 (25%) used both, and 2 patients used neither. All patients used either saline or soap and water. There was no significant difference in infection rates among these groups after Bonferroni correction (p>0.0063). However, patients with CAD exhibited higher rates of peritonitis (p=0.02). Adherence to prescribed exit-site care was inconsistent, with 28 patients deviating from initial instructions; however, there was no statistically significant difference in CRIs (p=0.5) or peritonitis rates (p=0.5) between adherent and non-adherent patients. Eleven patients reported CRIs not documented in the medical records.
Conclusions:
Type of antiseptic use and adherence to exit-site care practices did not significantly impact CRI rates. However, CAD was associated with higher risk of peritonitis.