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ISPD Catheter-related Infection Recommendations: 2023 Update

Chow KM 1 , Li PK 1 , Cho Y 2 , Abu-Alfa A 3 , Bavanandan S 4 , Brown EA 5 Show all authors , Cullis B 6 , Edwards D 7 , Ethier I 8 , Hurst H 9 , Ito Y 10 , de Moraes TP 11 , Morelle J 12 , Runnegar N 13 , Saxena A 14 , So SW 15 , Tian N 16 , Johnson DW 2

Affiliations 

  • 1 Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
  • 2 Australasian Kidney Trials Network, University of Queensland, Brisbane, Australia
  • 3 Division of Nephrology and Hypertension, American University of Beirut, Lebanon
  • 4 Department of Nephrology, Hospital Kuala Lumpur, Malaysia
  • 5 Imperial College Renal and Transplant Centre, Imperial College NHS Trust, London, UK
  • 6 Department of Nephrology and Child Health, University of Cape Town, South Africa
  • 7 National Forum of ESRD Networks, Kidney Patient Advisory Council (KPAC), USA
  • 8 Division of Nephrology, Centre hospitalier de l'Université de Montréal, Canada
  • 9 School of Health and Society, University of Salford, Salford Royal, Northern Care Alliance Trust, UK
  • 10 Department of Nephrology and Rheumatology, Aichi Medical University, Nagakute, Japan
  • 11 Programa de Pós-Graduação em Ciências da Saúde, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
  • 12 Division of Nephrology, Cliniques universitaires Saint-Luc, Brussels, Belgium
  • 13 Infectious Management Services, Princess Alexandra Hospital, University of Queensland, Brisbane, Australia
  • 14 Department of Medicine, Division of Nephrology, Stanford University, CA, USA
  • 15 Department of Pharmacy, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong
  • 16 Department of Nephrology, General Hospital of NingXia Medical University, Yinchuan, China
Perit Dial Int, 2023 May;43(3):201-219.
PMID: 37232412 DOI: 10.1177/08968608231172740

Abstract

Peritoneal dialysis (PD) catheter-related infections are important risk factors for catheter loss and peritonitis. The 2023 updated recommendations have revised and clarified definitions and classifications of exit site infection and tunnel infection. A new target for the overall exit site infection rate should be no more than 0.40 episodes per year at risk. The recommendation about topical antibiotic cream or ointment to catheter exit site has been downgraded. New recommendations include clarified suggestion of exit site dressing cover and updated antibiotic treatment duration with emphasis on early clinical monitoring to ascertain duration of therapy. In addition to catheter removal and reinsertion, other catheter interventions including external cuff removal or shaving, and exit site relocation are suggested.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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