Frequent involvement of the internal cuff segment in CAPD peritonitis and exit-site infection--an ultrasound study

Korzets, Ze’ev; Erdberg, A.; Golan, Eliezer; Ben-Chitrit, S.; Verner, Marc-André; Rathaus, Valeria; Bernheim, Jacques

doi:10.1093/oxfordjournals.ndt.a027263

Cited by 46 publications

(27 citation statements)

References 3 publications

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“…Some patients with clinical features of ESI alone actually have occult infection of the catheter tunnel and internal cuff, which may be revealed by sonography (15,(176)(177)(178), and the presence of occult tunnel involvement predicts subsequent catheter loss (177). Possible indications for ultrasonographic examination of catheter tunnel are summarized in Table 3.…”

Section: Clinical Presentation and Assessmentmentioning

confidence: 99%

ISPD Catheter-Related Infection Recommendations: 2017 Update

et al. 2017

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Section: Clinical Presentation and Assessmentmentioning

confidence: 99%

ISPD Catheter-Related Infection Recommendations: 2017 Update

et al. 2017

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“…Tunnel involvement was detected by US in seven (53.8%) of the 13 patients with peritonitis, in four of five S. aureus induced peritonitis, in one of two S. epidermidis peritonitis and in one of three gram negative peritonitis and two of three peritonitis without any grown. In the study reported by Korzets et al [13] in peritonitis the findings were mainly localized to the internal cuff region. Our findings were in agreement with those of Korzets et al [13].…”

Section: Discussionmentioning

confidence: 83%

“…In the study reported by Korzets et al [13] in peritonitis the findings were mainly localized to the internal cuff region. Our findings were in agreement with those of Korzets et al [13].…”

Section: Discussionmentioning

confidence: 83%

Ultrasound Evaluation of Peritoneal Catheter Tunnel in Catheter Related Infections in CAPD

Karahan¹,

Taşkapan²,

Yıkılmaz³

et al. 2005

Int Urol Nephrol

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In cases of peritonitis and exit site infections it is important to determine the extent of involvement of the subcutaneous catheter tract. The assessment of such involvement by physical examination alone appears to be inadequate and insensitive. We examined the usefulness of ultrasound (US) examination of the catheter tract in delineating catheter related infections, and their relationship to each other and to peritonitis. Patients were examined during clinically defined states of exit-site infection (ESI), clinically defined tunnel infection (TI), peritonitis and in the normal condition. US examinations of the catheter tunnel were performed in 44 CAPD patients. A total of 47 US examinations (examination was repeated in three patients) were performed, divided among 13 episodes of peritonitis, four ESI, and 30 controls. In 12 of 47 US examinations, US-defined TI was demonstrated as a sonolucent pericatheteric fluid collection. These 12 positive US were distributed among seven patients with peritonitis, three with exit-site infections and two control patients. We conclude that peritonitis and ESIs are frequently accompanied by involvement of the catheter tract. It seems that both the internal and external cuffs do not constitute an effective barrier against the spread of infection.

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“…Using clinical criteria, rates of tunnel infection (primarily S. aureus) are 0.12/year, while with the use of sonography, rates climb to 0.35/ year. At least 50% of S. aureus exit-site infections are associated with tunnel infections [57][58][59][60].…”

Section: Diagnosis and Management Of Exit-site And Tunnel Infectionsmentioning

confidence: 99%

Peritoneal Catheters and Related Infections

Thodis¹,

Passadakis²,

Lyrantzopooulos

et al. 2005

Int Urol Nephrol

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Catheter related infectious complications (exit-site infections, tunnel infections, and peritonitis) remain the major reasons for technique failure during the three decades since, continuous ambulatory peritoneal dialysis (CAPD) treatment has been first established. Despite improvements in catheter's survival rates, catheter related complications result in an increase in the cumulative patients' morbidity and often leading to the catheter removal. The ideal catheter provides reliable and rapid dialysate flow rates without leaks or infections. Among several types, the double-cuff straight Tenckhoff catheter, developed in 1968, is still the most widely used, although its use is decreasing in favour of swanneck catheters. Although there are only few well-designed trials comparing catheters and catheters related infectious complications, controlling for all other important variables, no difference in these complications among the main types of catheters was seen. The single cuff catheters have been associated with a shorter survival rate and time to the first peritonitis episode than the double-cuff catheters. Also exit-site infections were found to be more frequent and significantly more resistant to treatment with single-cuff compared to double-cuff ones. Finally, better results have been reported with the latest developed presternal peritoneal dialysis catheter both regarding survival rates and exit-site infection and peritonitis rates. Recently a renewed interest in continuous flow peritoneal dialysis stimulated inventions of imaginative, double-lumen catheters since a suitable peritoneal access is a sine qua non condition for the development of this new technique of peritoneal dialysis.

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Frequent involvement of the internal cuff segment in CAPD peritonitis and exit-site infection--an ultrasound study

Cited by 46 publications

References 3 publications

ISPD Catheter-Related Infection Recommendations: 2017 Update

ISPD Catheter-Related Infection Recommendations: 2017 Update

Ultrasound Evaluation of Peritoneal Catheter Tunnel in Catheter Related Infections in CAPD

Peritoneal Catheters and Related Infections

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