Gorban-Brennan N, Raffone RD, Troidle L, Kliger AS,
Finkelstein FO
The relationship between exit-site infection and peritonitis
17th Annual CAPD Conference
Perit Dial Int Suppl 1
(Feb) 17:S31 1997
The questions are: Does exit site infection (ESI) lead to peritonitis, and
does peritonitis lead to ESI? It often is argued that ESI is only cosmetic
and not usually a cause of peritonitis.
In this study, 139 patients starting on PD were followed for a period of 2
years. During this time 126 episodes of peritonitis and 126 episodes of
ESI were encountered. The possible links between antecedent ESI and P were
examined. If ESI preceded peritonitis by < 3 months and was due to the
same organism with the same antibiotic sensitivity, causality was inferred.
Similarly, if an episode of ESI was preceded by peritonitis with the same
organism, causality in the other direction was proposed.
It was found that only 6% of peritonitis episodes were linked to an
antecedent episode of ESI in this manner. ESI was never preceded by
peritonitis with the same organism. The authors thus question if
improvement of ESI rates will lead to reduction of peritonitis.
Comment: This study should be repeated and extended. It is an
extremely important observation if true.
(Stephen Vas, M.D., University of Toronto, Canada)
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17th Annual CAPD Conference
Basic peritoneal dialysis :
Peritonitis and exit-site infection
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