Comparison of Exit-Site Infection Frequency in Continuous Ambulatory Peritoneal Dialysis and Automated Peritoneal Dialysis Patients: A Single-Center Experience

Abstract

Objectives: Catheter exit-site infection (ESI) is generally caused by skin flora. Continuous ambulatory peritoneal dialysis (CAPD) patients have more contact with their catheters than automated peritoneal dialysis (APD) patients as a result of performing multiple exchanges per day. the aim of the present study was to compare the frequency of ESIs between these 2 peritoneal dialysis (PD) modalities. Methods: PD patients from 2001 to 2015 were enrolled in the study. Patients transferred from CAPD to APD were excluded. All of the data were collected retrospectively. the rate of ESI occurrence and culture results in the CAPD and APD groups were compared. Results: the data of 280 patients were evaluated. APD patients represented 23.2% of the study cohort. Prevalence of peritonitis was 87.6% if a patient had an ESI and 50.7% if there was no ESI (p=0.000). the frequency of ESI was similar between the 2 peritoneal dialysis modalities (p=0.343). There was a statistically significant difference in the causative organism of infection between the 2 groups (p=0.021). Conclusion: the ESI rate was similar in the CAPD and APD patients though CAPD requires more exchanges, and therefore there is more contact with the catheter. All PD patients, regardless of the treatment modality used, are expected to perform exchanges according to standard rules for connecting the catheter to the PD solution bag. As long as patients observe these guidelines, there would appear to be no increased ESI risk related specifically to the modality.