TY - JOUR AU - Silva, Filipa Sofia AU - Tavares, Joana AU - Correia, Sofia O AU - Freitas, Cristina AU - santos, Olivia AU - Carvalho, Maria João AU - Malheiro, Jorge AU - Cabrita, António AU - Rodrigues, Anabela PY - 2019/09/14 Y2 - 2024/03/19 TI - Exit site infection in peritoneal dialysis : predictive factors for adverse outcome JF - Bulletin de la Dialyse à Domicile JA - Bull Dial Domic VL - 2 IS - 3 SE - Articles DO - 10.25796/bdd.v2i3.21333 UR - https://bdd.rdplf.org/index.php/bdd/article/view/21333 SP - 127-134 AB - <p>Infection-related complications in patients on peritoneal dialysis (PD) is a leading complication.</p><p>Our aim was to evaluate the type and natural course of ESI events in a cohort of PD treated in last decade of our PD program.</p><p>Registry data of ESI events (n=126, in 74 patients<u>)</u> were retrieved. ESI protocols followed standard international guidelines. A systematic quality control is performed.</p><p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The median follow-up was 29.1 (14.0-47.4) months. In this population the adverse outcomes of TI rate and peritonitis rate was 0.12 and 0.13 patient/year, respectively. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Male sex (0.048), older age (0.007) and <em>Staphylococcus aureus</em> (SA) agent (0.006) were predictive of TI while non-optional PD and lower levels of albumin were predictive of peritonitis.&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; After grouping the ESI events according to the date of the occurrence of infection (group 1: 2008 to 2012, group 2: 2013 to 2017 and group 3: 2018) a substantial increase of TI in 2018 was evident (P &lt;0.001 when comparing group 3 vs 1 and 0.005 when comparing group 2 and 3).&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; When ESI occurs simultaneous with TI, the probability of not reaching cure is 65%. Drop-out occurred in 50% of ESI without peritonitis vs 86% with peritonitis (P &lt;0.001). <em>SA</em> is the microorganism most implicated in the failure to heal (P 0.002) and drop-out (P 0.010).</p><p>In spite of a number of efforts to reduce ESI, a regular audit still point to the need for protocols review in order to avoid adverse outcomes. Focused training of patients is mandatory but also prophylaxis and antibiotic protocols deserve improvement.</p> ER -