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Current epidemiology and practice patterns in prevention and treatment of PD-related infections in Poland

  • Monika Lichodziejewska-NiemierkoEmail author
  • Michał Chmielewski
  • Ewa Wojtaszek
  • Ewa Suchowierska
  • Edyta Gołembiewska
  • Magdalena Grajewska
  • Joanna Matuszkiewicz-Rowińska
  • Beata Naumnik
  • Beata Sulikowska
  • Stanisław Niemczyk
  • Renata Kłak
  • Magdalena Mosakowska
  • Piotr Jagodziński
  • Bernadeta Marcykiewicz
  • Krzysztof Kalita
  • Robert Krawczyk
  • Krzysztof Cieszyński
  • Mirosław Adamski
  • Marek Bronk
Nephrology - Original Paper
  • 46 Downloads

Abstract

Background

Peritoneal dialysis (PD) related infections are associated with technique failure and mortality. The aim of this multicentre study was to examine epidemiology, treatment and outcomes of PD-related infections in Poland as well as practice patterns for prevention of these complications in the context of current ISPD recommendations.

Methods

A survey on PD practices in relation to infectious complications was conducted in 11 large Polish PD centres. Epidemiology of peritonitis and exit-site infections (ESI) was examined in all patients treated in these units over a 2 year period.

Results

The study included data on 559 PD patients with 62.4% on CAPD. Practice patterns for prevention of infectious complications are presented. The rate of peritonitis was 0.29 episodes per year at risk, with Gram positive microorganisms responsible for more than 50% of infections and 85.8% effectively treated. Diagnosis and treatment followed ISPD guidelines however most units did not provide an anti-fungal prophylaxis. Although neither of the centres reported routine topical mupirocin on catheter exit-site, the rate of ESI was low (0.1 episodes per year at risk), with Staphylococcus aureus as most common pathogen and full recovery in 78.3% of cases.

Conclusion

The study shows rewarding outcomes in prevention and treatment of PD-associated infections, mainly due to a thorough compliance with the current ISPD guidelines, although some deviations from the recommendations in terms of practice patterns have been observed. More studies are needed in large numbers of patients to differentiate the importance of specific recommendations and further support the guidelines.

Keywords

Peritoneal dialysis Infection Peritonitis 

Notes

Funding

There was no funding to the study.

Compliance with ethical standards

Conflict of interest

MLN,JMR,EG,BS,MG,PJ - Speaker’s honoraria from Fresenius Medical Care, MLN,MC,BN,EG,BS,EW,ES,MG,RK- Speaker’s honoraria from Baxter, BN,BS - Speaker’s honoraria from MSD, BN - Speaker’s honoraria from Amgen, JMR, BN,BS - Speaker’s honoraria from Roche, BS - Speaker’s honoraria from Servier, MLN,BN,JMR,EG,ES,BS,MG - Travel sponsorship from Fresenius Medical Care, BS - Travel sponsorship from Servier, MLN, PJ, BM, MA,KK,RK,KC - employees of Fresenius Nephrocare Dialysis Units, MB declares that he has no conflict of interest

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study contains retrospective observational data. For this type of study formal consent is not required. Protocol of the study received approval from the Local Bioethics Committee.

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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  • Monika Lichodziejewska-Niemierko
    • 1
    • 13
    Email author return OK on get
  • Michał Chmielewski
    • 1
  • Ewa Wojtaszek
    • 2
  • Ewa Suchowierska
    • 3
  • Edyta Gołembiewska
    • 4
  • Magdalena Grajewska
    • 5
  • Joanna Matuszkiewicz-Rowińska
    • 2
  • Beata Naumnik
    • 3
  • Beata Sulikowska
    • 5
  • Stanisław Niemczyk
    • 6
  • Renata Kłak
    • 7
  • Magdalena Mosakowska
    • 6
  • Piotr Jagodziński
    • 13
  • Bernadeta Marcykiewicz
    • 8
  • Krzysztof Kalita
    • 9
  • Robert Krawczyk
    • 10
  • Krzysztof Cieszyński
    • 10
  • Mirosław Adamski
    • 11
  • Marek Bronk
    • 12
  1. 1.Department of Nephrology, Transplantology and Internal MedicineMedical University of GdańskGdańskPoland
  2. 2.Department of Nephrology, Dialysis and Internal DiseasesMedical University of WarsawWarsawPoland
  3. 3.1st Department of Nephrology and Transplantation with Dialysis UnitMedical University of BiałystokBiałystokPoland
  4. 4.Department of Nephrology, Transplantology and Internal MedicinePomeranian Medical UniversitySzczecinPoland
  5. 5.Department of Nephrology, Hypertension and Internal Medicine, Collegium Medicum in BydgoszczNicolaus Copernicus University in ToruńBydgoszczPoland
  6. 6.Department of Internal Diseases, Nephrology and DialysisMilitary Institute of MedicineWarsawPoland
  7. 7.Department of Nephrology and Transplantation MedicineWrocław Medical UniversityWrocławPoland
  8. 8.Dialysis UnitFresenius NephrocareKrakówPoland
  9. 9.Dialysis UnitFresenius NephrocareSieradzPoland
  10. 10.Dialysis UnitFresenius NephrocareOstrów WielkopolskiPoland
  11. 11.Dialysis UnitFresenius NephrocareZabrzePoland
  12. 12.Clinical Microbiology LaboratoryUniversity Hospital of GdańskGdańskPoland
  13. 13.Dialysis UnitFresenius NephrocareGdańskPoland

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