Chlorhexidine-impregnated sponge dressing for prevention of catheter exit-site infection in peritoneal dialysis patients
- PDF / 626,414 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 100 Downloads / 182 Views
NEPHROLOGY - ORIGINAL PAPER
Chlorhexidine‑impregnated sponge dressing for prevention of catheter exit‑site infection in peritoneal dialysis patients: a pilot study Htay Htay1 · Jason Chon Jun Choo1 · David W. Johnson2,3,4,5 · Elaine M. Pascoe6 · Mathini Jayaballa1 · Elizabeth Ley Oei1 · Li Choo Ng1 · Sin Yan Wu1 · Marjorie Wai Yin Foo1 Received: 1 August 2020 / Accepted: 29 September 2020 © Springer Nature B.V. 2020
Abstract Purpose The study aimed to examine effect of chlorhexidine dressing in the prevention of peritoneal dialysis (PD)-related infection in PD patients. Methods This single-center pilot study recruited 50 incident PD patients to use weekly chlorhexidine dressing. The primary outcome was exit-site/tunnel infection rate. Secondary outcomes were peritonitis rate, time to first PD-related infection, infection-related hospitalization, technique and patient survival, adverse events, and chlorhexidine dressing acceptability. These clinical outcomes were compared with those of a historical cohort (2016–2017) using daily gentamicin cream. Results A total of 50 patients were recruited to use chlorhexidine and followed up for one year. The exit-site/tunnel infection rate was 0.09 (95% confidence interval [CI] 0.02–0.22) and peritonitis rate was 0.07 (95% CI 0.01–0.19) episodes per patientyear with chlorhexidine dressing. The 1-year infection-free survival rates for exit-site/tunnel infection and peritonitis were 92% and 94%, respectively. The 1-year technique and patient survival rates were 86% and 96%, respectively. Overall, 12% of participants developed localized contact dermatitis with chlorhexidine. Most participants (73%) reported that chlorhexidine dressings were very acceptable. Compared to a historical cohort using gentamicin cream (n = 238), the chlorhexidine group had similar exit-site/tunnel infection rates (incidence rate ratio [IRR] 0.65, 95% CI 0.22–1.92) but had lower peritonitis rates (IRR 0.24, 95% CI 0.07–0.77), and lower PD infection-related hospitalization rates (IRR 0.21, 95% CI 0.06–0.69) after adjusting for age, sex, race, primary kidney disease, and diabetes mellitus. Conclusion Weekly chlorhexidine dressing was associated with acceptable PD-related infection outcomes and was wellaccepted by patients, although had a 12% rate of delayed localized contact dermatitis. Trial registration number and date The study was registered under www.clinicaltrials.gov with the reference number of NCT03406520 on 23 January 2018. Keywords Topical prophylaxis antibiotics · Catheter-related infections · Chlorhexidine dressing · Exit-site infection · Peritoneal dialysis
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11255-020-02674-w) contains supplementary material, which is available to authorized users. * Htay Htay [email protected] 1
Department of Renal Medicine, Singapore General Hospital, Academia, Level 3, 20 College Road, Singapore 169856, Singapore
2
Princess Alexandra Hospital, Brisbane, Australia
3
Centre for Kid
Data Loading...
