Imperial College London
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ProfessorEdwinaBrown

Faculty of Medicine, Department of Immunology and Inflammation

Professor of Renal Medicine
 
 
 
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Contact

 

+44 (0)20 3311 7590e.a.brown

 
 
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Location

 

Renal OfficesHammersmith HouseHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Beckwith:2019:10.3747/pdi.2018.00216,
author = {Beckwith, H and Clemenger, M and McGrory, J and Hisole, N and Chelapurath, T and Newbury, S and Corbett, RW and Brown, EA},
doi = {10.3747/pdi.2018.00216},
journal = {Peritoneal Dialysis International},
pages = {344--349},
title = {Repeat peritoneal dialysis exit-site infection: definition and outcomes},
url = {http://dx.doi.org/10.3747/pdi.2018.00216},
volume = {39},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: The most common complication of peritoneal dialysis (PD) is infection. Despite this, there are no clear guidelines for the management of repeat exit-site infection (ESI), and best practice is not known. We describe our unit's experience of repeat ESI and clinical outcomes in this cohort.Methods: Retrospective case note review of all PD patients with positive ESI swabs at our center between 1 January 2012 and 1 January 2018. Patients were included in the study if they had 2 or more ESI with the same organism within a 12-month period and an initial positive response to antibiotic therapy.Results: Overall, 31 of 248 patients had repeat ESI. The 2 most common causative organisms were Staphylococcus aureus (n = 16, 52%) and Pseudomonas aeruginosa (n = 10, 32%). Twenty (65%) patients developed subsequent peritonitis. The infection resolved with further antibiotics alone in 10 (32%) patients and in 6 patients after PD catheter exchange. The PD catheter was removed in 16 (52%) patients (including 5 after an initial catheter exchange) requiring transfer to hemodialysis (HD). Six (19%) patients died within 12 months of repeat ESI. Both repeat Pseudomonas aeruginosa and Staphylococcus aureus infections were associated with high rates of dialysis modality change (70% and 50%, respectively).Conclusion: We have developed the first definition for repeat ESI. Repeat ESI is clinically important and results in significant morbidity and mortality. Following repeat ESI, peritonitis rates are high and a significant number of patients switch dialysis modality. Studies are needed to determine whether interventions such as early catheter exchange would improve outcomes.
AU  - Beckwith,H
AU  - Clemenger,M
AU  - McGrory,J
AU  - Hisole,N
AU  - Chelapurath,T
AU  - Newbury,S
AU  - Corbett,RW
AU  - Brown,EA
DO  - 10.3747/pdi.2018.00216
EP  - 349
PY  - 2019///
SN  - 0896-8608
SP  - 344
TI  - Repeat peritoneal dialysis exit-site infection: definition and outcomes
T2  - Peritoneal Dialysis International
UR  - http://dx.doi.org/10.3747/pdi.2018.00216
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000474846100009&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://www.pdiconnect.com/content/39/4/344
VL  - 39
ER  -
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