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共识与指南

2023版国际腹膜透析协会腹膜透析导管相关感染防治指南建议解读

  • 成水芹 ,
  • 余乐 ,
  • 张志宏 ,
  • 俞雨生
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  • 210016 南京,1东部战区总医院肾内科 国家肾脏疾病临床医学研究中心 全军肾脏病研究所

收稿日期: 2023-10-10

  修回日期: 2023-10-14

  网络出版日期: 2024-02-12

基金资助

国家卫生和计划生育委员会重点项目(YYS2016001)

Interpretation of the 2023 International Society for Peritoneal Dialysis guideline recommendations for prevention and treatment of peritoneal dialysis catheter-related infection

  • CHENG Shui-Qin ,
  • YU Le ,
  • ZHANG Zhi-Hong ,
  • YU Yu-Sheng
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  • Department of Nephrology, National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210016, China

Received date: 2023-10-10

  Revised date: 2023-10-14

  Online published: 2024-02-12

摘要

腹膜透析(peritoneal dialysis,PD)导管相关感染是PD患者的严重并发症,是PD导管拔除和腹膜炎发生的重要危险因素,影响PD患者的预后。2023年5月国际腹膜透析协会(International Society for Peritoneal Dialysis,ISPD)更新了《腹膜透析导管相关感染的防治指南建议》,修订和明确了PD导管出口处感染(exit site infection,ESI)和隧道感染的定义和分类,其中要求PD导管ESI的感染率不应超过每年0.4例,关于PD导管相关感染的预防和治疗提出了具体的建议,最后指出了未来研究方向。本文就该指南内容作一解读。

本文引用格式

成水芹 , 余乐 , 张志宏 , 俞雨生 . 2023版国际腹膜透析协会腹膜透析导管相关感染防治指南建议解读[J]. 中国血液净化, 2024 , 23(02) : 81 -85 . DOI: 10.3969/j.issn.1671-4091.2024.02.001

Abstract

Peritoneal dialysis (PD) catheter-related infection is a serious complication in PD patients, being an important risk factor for drawing out of PD catheter and peritonitis and affecting prognosis of the PD patients. In May 2023, the International Society for Peritoneal Dialysis (ISPD) updated the guideline recommendations for PD catheter-related infection, revised and clarified the definition and classification of PD catheter exit site infection (ESI) and tunnel infection. A new target that overall PD catheter ESI rate should be less than 0.4 episodes per year was established. The specific recommendation for prevention and treatment of PD catheter-related infections was provided, and the research direction of PD catheter-related infections was proposed. In this review, we present an interpretation on this guideline.

参考文献

[1] Szeto CC, Li PK, Johnson DW, et al. ISPD Catheter-Related Infection Recommendations: 2017 Update[J]. Perit Dial Int, 2017, 37(2): 141-154.
[2] Chow KM, Li PK, Cho Y, et al. ISPD Catheter-related Infection Recommendations: 2023 Update[J]. Perit Dial Int, 2023, 43(3): 201-219.
[3] Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations[J]. BMJ, 2004, 328(7454): 1490.
[4] Crabtree JH, Shrestha BM, Chow KM, et al. Creating and Maintaining Optimal Peritoneal Dialysis Access in the Adult Patient: 2019 Update[J]. Perit Dial Int, 2019, 39(5): 414-436.
[5] 李红波,李耶,丁艳琼,等. 单中心腹膜透析导管相关感染病原菌及耐药性分析[J]. 中华肾脏病杂志,2019,35(2):139-141. DOI:10.3760/cma.j.issn.1001-7097.2019.02.010.
[6] Htay H, Johnson DW, Craig JC, et al. Catheter type, placement and insertion techniques for preventing catheter-related infections in chronic peritoneal dialysis patients[J]. Cochrane Database Syst Rev, 2019, 5(5): CD004680.
[7] Campbell D, Mudge DW, Craig JC, et al. Antimicrobial agents for preventing peritonitis in peritoneal dialysis patients[J]. Cochrane Database Syst Rev, 2017, 4(4): CD004679.
[8] Khandelwal M, Bailey S, Izatt S, et al. Structural changes in silicon rubber peritoneal dialysis catheters in patients using mupirocin at the exit site[J]. Int J Artif Organs, 2003, 26(10): 913-917.
[9] Gardezi AI, Schlageter KW, Foster DM, et al. Erosion of the Silicone Peritoneal Dialysis Catheter with the Use of Gentamicin Cream at the Exit Site[J]. Adv Perit Dial, 2016, 32(15-18.
[10] Boudville N, Johnson DW, Zhao J, et al. Regional variation in the treatment and prevention of peritoneal dialysis-related infections in the Peritoneal Dialysis Outcomes and Practice Patterns Study[J]. Nephrol Dial Transplant, 2019, 34(12): 2118-2126.
[11] Bennett PN, Bohm C, Harasemiw O, et al. Physical activity and exercise in peritoneal dialysis: International Society for Peritoneal Dialysis and the Global Renal Exercise Network practice recommendations[J]. Perit Dial Int, 2022, 42(1): 8-24.
[12] Li PK, Chow KM, Cho Y, et al. ISPD peritonitis guideline recommendations: 2022 update on prevention and treatment[J]. Perit Dial Int, 2022, 42(2): 110-153.
[13] 成水芹,俞雨生.腹膜透析导管出口处感染的诊疗新进展[J]. 肾脏病与透析肾移植杂志,2022,31(3):281-285,295. DOI:10.3969/j.issn.1006-298X.2022.03.016.
[14] Au CWH, Yap DYH, Chan JFW, et al. Exit site infection and peritonitis due to Serratia species in patients receiving peritoneal dialysis: Epidemiology and clinical outcomes[J]. Nephrology (Carlton), 2021, 26(3): 255-261.
[15] Yap DY, Choy CB, Mok MM, et al. Burkholderia cepacia-an uncommon cause of exit-site infection in a peritoneal dialysis patient[J]. Perit Dial Int, 2014, 34(4): 471-472.
[16] Hui YH, So WK, Ng MS, et al. Treating peritoneal dialysis catheter exit-site granulomas with chlorhexidine swabstick: A pilot study[J]. J Ren Care, 2021, 47(2): 103-112.
[17] Matinfar M, Taheri S, Karimi S, et al. Successful treatment of peritoneal dialysis catheter exit-site granuloma with silver ion-based dressing[J]. J Vasc Access, 2021, 22(4): 685-686.
[18] Gleeson S, Mulroy E, Bryce E, et al. Burkholderia cepacia: An Outbreak in the Peritoneal Dialysis Unit[J]. Perit Dial Int, 2019, 39(1): 92-95.
[19] Meng C, Beco A, Oliveira A, et al. Peritoneal Dialysis Cuff-Shaving-A Salvage Therapy for Refractory Exit-Site Infections[J]. Perit Dial Int, 2019, 39(3): 276-281.
[20] Tan SY, Thiruventhiran T. Catheter cuff shaving using a novel technique: a rescue treatment for persistent exit-site infections[J]. Perit Dial Int, 2000, 20(4): 471-472.
[21] Scalamogna A, Nardelli L, Castellano G. The use of mini-invasive surgical techniques to treat refractory exit-site and tunnel infections in peritoneal dialysis patients: a clinical approach[J]. J Nephrol, 2022,
[22] Kirmizis D, Bowes E, Ansari B, et al. Exit-Site Relocation: A Novel, Straightforward Technique for Exit-Site Infections[J]. Perit Dial Int, 2019, 39(4): 350-355.
[23] Oki R, Hamasaki Y, Komaru Y, et al. Catheter Diversion Procedure With Exit-Site Renewal Promotes Peritoneal Dialysis Catheter Survival[J]. Kidney Int Rep, 2021, 6(2): 325-332.
[24] Soon JJY, Ng NZP, Lee SQ, et al. Are salvage techniques safe and effective in the treatment of peritoneal dialysis catheter-related exit-site and tunnel infections? A systematic review and description of the authors' preferred technique[J]. Perit Dial Int, 2022, 42(6): 591-601.
[25] Muraoka K, Ishibashi Y, Yamaguchi J, et al. Early partial re-implantation of Tenckhoff catheters to treat intractable exit-site or tunnel infection[J]. Perit Dial Int, 2011, 31(3): 350-353.
[26] Kwan TH, Tong MK, Siu YP, et al. Ultrasonography in the management of exit site infections in peritoneal dialysis patients[J]. Nephrology (Carlton), 2004, 9(6): 348-352.
[27] Vychytil A, Lorenz M, Schneider B, et al. New criteria for management of catheter infections in peritoneal dialysis patients using ultrasonography[J]. J Am Soc Nephrol, 1998, 9(2): 290-296.
[28] Beckwith H, Clemenger M, Mcgrory J, et al. Repeat Peritoneal Dialysis Exit-Site Infection: Definition and Outcomes[J]. Perit Dial Int, 2019, 39(4): 344-349.
[29] Nadarajah L, Yaqoob MM, Fan S. Persistent colonization of exit site is associated with modality failure in peritoneal dialysis[J]. Perit Dial Int, 2022, 42(1): 96-99.
[30] Carson CF, Ash O, Chakera A. In vitro data support the investigation of vinegar as an antimicrobial agent for PD-associated Pseudomonas exit site infections[J]. Nephrology (Carlton), 2017, 22(2): 179-181.
[31] Granata A, Rahbari E, Di Nicolo P, et al. The Underrated Role of Ultrasound in Peritoneal Dialysis[J]. J Ultrasound Med, 2022, 41(2): 301-310.
[32] Bnaya A, Wiener-Well Y, Soetendorp H, et al. Nontuberculous mycobacteria infections of peritoneal dialysis patients: A multicenter study[J]. Perit Dial Int, 2021, 41(3): 284-291.

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