Abstract:As peritoneal dialysis (PD)-related fungal infection is associated with a high mortality rate, the international guidelines recommend immediate removal of the PD catheter in conjunction with at least 2-weeks of antifungal treatment. Some authors have reported successful management of such cases without removing the PD catheter - by instilling an antifungal lock into the retained PD catheter. However, the use of antifungal locks has generally not been well accepted as the standard treatment for fungal peritonit… Show more
“…Such infections arise from bacterial adhesion to biomaterial surfaces with subsequent formation of antibiotic-refractory biofilms that are challenging to handle with in situ intraperitoneal antibiotics. Ex vivo studies of PD catheters removed from patients experiencing peritonitis showed that such catheters are covered by microbial biofilms usually composed of a single species or mixed microbial populations ( 8 – 10 ). The abundant extracellular polymeric matrix embedding these microbial communities leads to inadequate penetration into biofilms of standard intraperitoneal antibiotics, resulting in a high rate of relapsing infections which are treated only by catheter removal.…”
Section: Introductionmentioning
confidence: 99%
“…Most studies in the field of catheter-related infections have focused on the use of antibiotic lock treatment as a therapeutic option for intravascular catheter-related infections. Currently, only a few studies have investigated the effects of lock therapy on microbial biofilms in PD ( 8 – 10 ). In hemodialysis, antimicrobial lock solution has been proven to be such an effective adjunctive treatment for biofilm-associated central venous catheter-related infections ( 11 – 14 ) that lock solution is nowadays the recommended rescue procedure for colonized intravascular catheters ( 15 ).…”
An
in vitro
model allows studies of the mechanisms by which the lock solutions exert their antimicrobial effects on catheter-associated biofilm, thus providing a better understanding of the management of devise-associated infections.
“…Such infections arise from bacterial adhesion to biomaterial surfaces with subsequent formation of antibiotic-refractory biofilms that are challenging to handle with in situ intraperitoneal antibiotics. Ex vivo studies of PD catheters removed from patients experiencing peritonitis showed that such catheters are covered by microbial biofilms usually composed of a single species or mixed microbial populations ( 8 – 10 ). The abundant extracellular polymeric matrix embedding these microbial communities leads to inadequate penetration into biofilms of standard intraperitoneal antibiotics, resulting in a high rate of relapsing infections which are treated only by catheter removal.…”
Section: Introductionmentioning
confidence: 99%
“…Most studies in the field of catheter-related infections have focused on the use of antibiotic lock treatment as a therapeutic option for intravascular catheter-related infections. Currently, only a few studies have investigated the effects of lock therapy on microbial biofilms in PD ( 8 – 10 ). In hemodialysis, antimicrobial lock solution has been proven to be such an effective adjunctive treatment for biofilm-associated central venous catheter-related infections ( 11 – 14 ) that lock solution is nowadays the recommended rescue procedure for colonized intravascular catheters ( 15 ).…”
An
in vitro
model allows studies of the mechanisms by which the lock solutions exert their antimicrobial effects on catheter-associated biofilm, thus providing a better understanding of the management of devise-associated infections.
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