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ISPD Guidelines for Catheter-Associated Infections 2023
DOI: https://dx.doi.org/10.18565/nephrology.2024.3.73-90
Kai Ming Chow, Philip Kam-Tao Li, Yeoungjee Cho, Ali Abu-Alfa, Sunita Bavanandan, Edwina A Brown, Brett Cullis, Dawn Edwards, Isabelle Ethier, Helen Hurst, Yasuhiko Ito, Thyago Proenc¸ a de Moraes, Johann Morelle, Naomi Runnegar, Anjali Saxena, Simon Wai-Yin So, Na Tian, David W Johnson.
1) Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China; 2) Carol & Richard Yu Peritoneal Dialysis Research Centre, Faculty of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; 3) Australian Kidney Clinical Research Network, University of Queensland, Brisbane, Australia; 4) Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia; 5) Department of Nephrology and Hypertension, American University Hospital, Beirut, Lebanon; 6) Department of Nephrology, Yale School of Medicine, New Haven, CT, USA; 7) Department of Nephrology, Kuala Lumpur Hospital, Malaysia; 8) Imperial College Kidney and Transplant Centre, Imperial College NHS Trust, London, UK; 9) Department of Nephrology and Child Health, University of Cape Town,South Africa; 10) National ESRD Forum, Renal Failure Patient Advisory Council, USA; 11) Department of Nephrology, Montreal University Hospital, Montreal, Canada; 12) Centre for Innovation and Evaluation in Health, Montreal University Hospital Research Centre, Montreal, Canada; 13) School of Health and Society, University of Salford, Salford Royal, Northern Care Alliance Trust, UK; 14) Department of Nephrology and Rheumatology, Aichi University of Medicine, Nagakute, Japan; 15) Post-Graduation Programme in Sciences do Saude, Pontifical Catholic University of Paran´, Curitiba, Brazil; 16) Department of Nephrology, Saint-Luc University Hospital, Brussels, Belgium; 17) Infection Service, Princess Alexandra Hospital, University of Queensland, Brisbane, Australia; 18) School of Medicine, Department of Nephrology, Stanford University, California, USA; 19) School of Medicine, Department of Nephrology, Santa Clara Valley Medical Centre, San Jose, California, USA; 20) Department of Pharmacy, Alice Ho Miulin Nethersole Hospital, Taipo, Hong Kong; 21) Department of Nephrology, General Hospital of Ningxia Medical University, Yinchuan, China
Catheter-associated infections are important risk factors for catheter loss and peritonitis. The Guidelines 2023 update revise and clarifiy the definitions and classifications of catheter exit site infection and tunnel infection. The new target for overall catheter exit site infection rate is 0.40 or fewer episodes per year, based on risk. The recommendation for topical antibiotic cream or ointment to the catheter exit site has been downgraded.
The new guidelines include clarification on exit site dressing and updated duration of antibiotic treatment, with an emphasis on early clinical monitoring to guide duration of therapy. In addition to catheter removal and reinsertion, other catheter interventions are suggested, including outer cuff removal or shaving, and exit site relocation.
The new guidelines include clarification on exit site dressing and updated duration of antibiotic treatment, with an emphasis on early clinical monitoring to guide duration of therapy. In addition to catheter removal and reinsertion, other catheter interventions are suggested, including outer cuff removal or shaving, and exit site relocation.
Keywords: ISPD Guidelines, exit site infection, catheter-associated infections, antibiotic prophylaxis, antibacterial agents, peritoneal dialysis, outcomes, prevention
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