Infecting Organisms in Continuous Ambulatory Peritoneal Dialysis Patients on the Y-set

Jean L. Holley, Judith Bernardini, Beth Piraino

Research output: Contribution to journalArticle

Abstract

Disconnect systems for performing continuous ambulatory peritoneal dialysis (CAPD) use a flush-before-fill technique that should theoretically reduce the peritonitis caused by touch contamination. However, little information about the infecting organisms in CAPD-related infections using disconnect systems is available. We performed a retrospective matched-case controlled study to define the organisms responsible for the peritonitis and catheter infections seen in CAPD patients using the Y-set without disinfectant. One hundred nineteen patients who began CAPD on the Y-set were matched with 119 patients who began CAPD on the standard spike system. Patients were matched for age, sex, race, insulin dependence, and time on CAPD. Infection data were prospectively collected for all patients. Peritonitis, exit site, and tunnel infection rates (expressed as number of episodes per patient-year) were all significantly lower in the Y-set patients (0.56 v 0.94, 0.68 v 1.08, and 0.14 v 0.22, respectively). The lower peritonitis rate in the Y-set patients compared with that found in the standard spike system patients was due to a reduction in Staphylococcus epidermidis (0.17 v 0.26, P = 0.02), polymicrobial (0.014 v 0.06, P = 0.01), other gram-positive (0.007 v 0.09, P = 0.001), and sterile (0.10 v 0.19, P = 0.008) peritonitis. Rates of Staphylococcus aureus and gram-negative peritonitis were not different among the two groups. S epidermidis (0.12 v 0.23, P = 0.0014) and gram-negative (0.12 v 0.18, P = 0.04) exit site infection rates were also lower in the Y-set patients. Similarly, the catheter removal rate for infectious causes was lower in the Y-set patients (0.14 v 0.28, P = 0.004), particularly for removal due to peritonitis (0.05 v 0.12, P = 0.007) and catheter infection (0.04 v 0.12, P = 0.003). Rates of S aureus infections and catheter removals were not different between the Y-set and standard spike patient groups. Disconnect systems reduce some infections caused by touch contamination, eg, those caused by S epidermidis, but have no effect on S aureus infections in CAPD patients.

Original languageEnglish (US)
Pages (from-to)569-573
Number of pages5
JournalAmerican Journal of Kidney Diseases
Volume23
Issue number4
DOIs
StatePublished - Jan 1 1994
Externally publishedYes

Keywords

  • Peritonitis
  • Staphylococcus aureus
  • catheter infections
  • disconnect systems
  • peritoneal dialysis

ASJC Scopus subject areas

  • Nephrology

Fingerprint Dive into the research topics of 'Infecting Organisms in Continuous Ambulatory Peritoneal Dialysis Patients on the Y-set'. Together they form a unique fingerprint.

  • Cite this