Update: Infektiöse Komplikationen der Peritonealdialyse

Zusammenfassung

Infektiöse Komplikationen stellen weiterhin eine wichtige Komplikation der Peritonealdialyse (PD) dar. Durch technische Entwicklungen der letzten Jahrzehnte sind heutzutage Peritonitisraten möglich, die unter 0,5 Ereignissen pro Jahr (kleiner als 1 Ereignis pro 24 Monate) liegen. Die Vermeidung von Exit-site-Infektionen und die perioperative Single-Shot-Antibiotikagabe stellen weitere Möglichkeiten dar, um Peritonitiden bei PD-Patienten zu vermeiden. Bei der Antibiotikaauswahl müssen lokale Resistenzen sowie koagulasenegative Staphylokokken mit Methicillin-/Oxacillinresistenz beachtet werden. Gramnegative Keime mit Resistenzen gegen Cephalosporine stellen weiterhin erfreulicherweise eine Ausnahme dar. Sollten solche Keime zu einer Peritonitis führen, kommen Carbapeneme intraperitoneal als Alternative in Frage.

• Literatur

• 1 Mujais S. Microbiology and outcomes of peritonitis in North America. Kidney Int Suppl 2006; (103) S55-62 doi:10.1038/sj.ki.5001916
• 2 Hsieh YP, Chang CC, Wen YK. et al. Predictors of peritonitis and the impact of peritonitis on clinical outcomes of continuous ambulatory peritoneal dialysis patients in Taiwan--10 years’ experience in a single center. Perit Dial Int 2014; 34: 85-94 doi: 10.3747/pdi.2012.00075
• 3 Hsieh YP, Chang CC, Wang SC. et al. Predictors for and impact of high peritonitis rate in Taiwanese continuous ambulatory peritoneal dialysis patients. Int Urol Nephrol 2015; 47: 183-189 doi: 10.1007/s11255–014–0763–5
• 4 van Esch S, Krediet RT, Struijk DG. 32 years’ experience of peritoneal dialysis-related peritonitis in a university hospital. Perit Dial Int 2014; 34: 162-170 doi: 10.3747/pdi.2013.00275
• 5 Peritonitis in continuous ambulatory peritoneal dialysis (CAPD): a multi-centre randomized clinical trial comparing the Y connector disinfectant system to standard systems. Perit Dial Int 1989; 9: 159-163
• 6 Li PK, Law MC, Chow KM. et al. Comparison of clinical outcome and ease of handling in two double-bag systems in continuous ambulatory peritoneal dialysis: a prospective, randomized, controlled, multicenter study. Am J Kidney Dis 2002; 40: 373-380 doi: 10.1053/ajkd.2002.34522
• 7 Fang W, Ni Z, Qian J. Key factors for a high-quality peritoneal dialysis program--the role of the PD team and continuous quality improvement. Perit Dial Int 2014; 34 (Suppl. 02) S35-42 doi:10.3747/pdi.2013.00120
• 8 Nishina M, Yanagi H, Kakuta T. et al. A 10-year retrospective cohort study on the risk factors for peritoneal dialysis-related peritonitis: a single-center study at Tokai University Hospital. Clin Exp Nephrol 2014; 18: 649-654 doi:10.1007/s10157–013–0872-y
• 9 Johnson DW, Brown FG, Clarke M. et al. The effects of biocompatible compared with standard peritoneal dialysis solutions on peritonitis microbiology, treatment, and outcomes: the balANZ trial. Perit Dial Int 2012; 32: 497-506 doi:10.3747/pdi.2012.00052
• 10 Johnson DW, Brown FG, Clarke M. et al. Effects of biocompatible versus standard fluid on peritoneal dialysis outcomes. J Am Soc Nephrol 2012; 23: 1097-1107 doi:10.1681/ASN.2011121201
• 11 Daly C, Cody JD, Khan I. et al. Double bag or Y-set versus standard transfer systems for continuous ambulatory peritoneal dialysis in end-stage kidney disease. Cochrane Database Syst Rev. 2014; (08) CD003078 doi:10.1002/14651858.CD003078.pub2
• 12 Li PK, Szeto CC, Piraino B. et al. ISPD peritonitis recommendations: 2016 update on prevention and treatment. Perit Dial Int 2016; 36: 481-508 doi:10.3747/pdi.2016.00078
• 13 Gadallah MF, Ramdeen G, Mignone J. et al. Role of preoperative antibiotic prophylaxis in preventing postoperative peritonitis in newly placed peritoneal dialysis catheters. Am J Kidney Dis 2000; 36: 1014-1019 doi:10.1053/ajkd.2000.19104
• 14 Cho Y, Johnson DW, Badve SV. et al. The impact of neutral-pH peritoneal dialysates with reduced glucose degradation products on clinical outcomes in peritoneal dialysis patients. Kidney Int 2013; 84: 969-979 doi:10.1038/ki.2013.190
• 15 Seo EY, An SH, Cho JH. et al. Effect of biocompatible peritoneal dialysis solution on residual renal function: a systematic review of randomized controlled trials. Perit Dial Int 2014; 34: 724-731 doi:10.3747/pdi.2012.00331
• 16 Nakayama M, Miyazaki M, Honda K. et al. Encapsulating peritoneal sclerosis in the era of a multi-disciplinary approach based on biocompatible solutions: the NEXT-PD study. Perit Dial Int 2014; 34: 766-774 doi:10.3747/pdi.2013.00074
• 17 Wu HH, Li IJ, Weng CH. et al. Prophylactic antibiotics for endoscopy-associated peritonitis in peritoneal dialysis patients. PLoS One 2013; 8: e71532 doi:10.1371/journal.pone.0071532
• 18 Strippoli GF, Tong A, Johnson D. et al. Antimicrobial agents to prevent peritonitis in peritoneal dialysis: a systematic review of randomized controlled trials. Am J Kidney Dis 2004; 44: 591-603
• 19 Lopes K, Rocha A, Rodrigues A. et al. Long-term peritoneal dialysis experience: quality control supports the use of fluconazole to prevent fungal peritonitis. Int J Artif Organs 2013; 36: 484-488 doi:10.5301/ijao.5000219
• 20 Huang WH, Yen TH, Chan MJ. et al. Impact of environmental particulate matter and peritoneal dialysis-related infection in patients undergoing peritoneal dialysis. Medicine (Baltimore) 2014; 93: e149 doi:10.1097/MD.0000000000000149
• 21 Domico J, Warman M, Jaykamur S. et al. Is ultrasonography useful in predicting catheter loss?. Adv Perit Dial 1993; 9: 231-232
• 22 Carmeci C, Muldowney W, Mazbar SA. et al. Emergency laparotomy in patients on continuous ambulatory peritoneal dialysis. Am Surg 2001; 67: 615-618
• 23 Suh H, Wadhwa NK, Cabralda T. et al. Endogenous peritonitis and related outcome in peritoneal dialysis patients. Adv Perit Dial 1996; 12: 192-195
• 24 Kitterer D, Latus J, Pohlmann C. et al. Microbiological surveillance of peritoneal dialysis associated peritonitis: antimicrobial susceptibility profiles of a referral center in Germany over 32 years. PLoS One 2015; 10: e0135969 doi:10.1371/journal.pone.0135969
• 25 Barretti P, Doles JV, Pinotti DG. et al. Efficacy of antibiotic therapy for peritoneal dialysis-associated peritonitis: a proportional meta-analysis. BMC Infect Dis 2014; 14: 445 doi: 10.1186/1471–2334–14–445
• 26 Leung CB, Szeto CC, Chow KM. et al. Cefazolin plus ceftazidime versus imipenem/cilastatin monotherapy for treatment of CAPD peritonitis--a randomized controlled trial. Perit Dial Int 2004; 24: 440-446
• 27 Chow KM, Szeto CC, Kwan BC. et al. Randomized controlled study of icodextrin on the treatment of peritoneal dialysis patients during acute peritonitis. Nephrol Dial Transplant. 2014; 29: 1438-1443 doi:10.1093/ndt/gfu033
• 28 van Diepen AT, Tomlinson GA, Jassal SV. The association between exit site infection and subsequent peritonitis among peritoneal dialysis patients. Clin J Am Soc Nephrol 2012; 7: 1266-1271 doi:10.2215/CJN.00980112
• 29 Szeto CC, Li PK, Johnson DW. et al. ISPD catheter-related infection recommendations: 2017 update. Perit Dial Int 2017; 37: 141-154 doi:10.3747/pdi.2016.00120
• 30 Xu G, Tu W, Xu C. Mupirocin for preventing exit-site infection and peritonitis in patients undergoing peritoneal dialysis. Nephrol Dial Transplant 2010; 25: 587-592 doi:10.1093/ndt/gfp411
• 31 Wong PN, Tong GM, Wong YY. et al. Alternating Mupirocin/Gentamicin is associated with increased risk of fungal peritonitis as compared with Gentamicin alone – results of a Randomized Open-Label Controlled Trial. Perit Dial Int 2016; 36: 340-346 doi:10.3747/pdi.2015.00237
• 32 Wong C, Luk IW, Ip M. et al. Prevention of gram-positive infections in peritoneal dialysis patients in Hong Kong: a cost-effectiveness analysis. Am J Infect Control 2014; 42: 412-416 doi:10.1016/j.ajic.2013.12.008
• 33 Johnson DW, Badve SV, Pascoe EM. et al. Antibacterial honey for the prevention of peritoneal-dialysis-related infections (HONEYPOT): a randomised trial. Lancet Infect Dis 2014; 14: 23-30 doi:10.1016/S1473–3099(13)70258–5
• 34 Rodriguez-Carmona A, Perez-Fontan M, Lopez-Muniz A. et al. Correlation between glycemic control and the incidence of peritoneal and catheter tunnel and exit-site infections in diabetic patients undergoing peritoneal dialysis. Perit Dial Int 2014; 34: 618-626 doi:10.3747/pdi.2012.00185