Subcutaneous gentamicin injection around the cuff in treatment of resistant exit site infection in peritoneal dialysis patients: a pilot study

Figures & data

Figure 1 An example of peritoneal dialysis catheter exit site infection (ESI).

Notes: (A) Before subcutaneous gentamicin injection into the pericatheteral area and (B) after subcutaneous gentamicin injection into the pericatheteral area.

Figure 2 Application of subcutaneous gentamicin injection into the pericatheteral area in a PD patient with ESI.

Abbreviations: ESI, exit site infection; PD, peritoneal dialysis.

Table 1 Demographic data and clinical characteristics of the study population

Variable	n=13
Age, median (range)	54 (33–78)
Gender, n (%)
Male	8 (61)
Female	5 (39)
Duration of CAPD, year, median (range)	4.5 (1–8)
Etiology of renal failure
Diabetic nephropathy	3
Hypertensive nephropathy	3
Chronic pyelonephritis	2
Nephrolithiasis	1
Others/unknown	4
Refractory ESI history, n (%)	2 (15)
Patients with cure, n (%)	11 (85)
Patients with recurrence, n (%)	1 (7.5)
Catheter removal, n (%)	1 (7.5)

Abbreviations: CAPD, continuous ambulatory peritoneal dialysis; ESI, exit site infection.

Table 2 Characteristics of patients with exit site infections (ESIs) who were administered subcutaneous gentamicin injection in the pericatheteral area

Patient	Gender	Culture of catheter exit site discharge	Gentamicin sensitivity	Culture of peritoneal fluid	Blood culture	Exit site score before treatment*	Exit site score after treatment*	Hospitalisation	Outcome
1	M	Staphylococcus aerus	Positive	No growth	No growth	5	0	No	Resolved
2	M	Pseudomonas aeruginosa	Positive	No growth	No growth	6	1	No	Resolved
3	M	S. aerus	Positive	No growth	S. aerus	8	6	No	Recurred
4	M	No growth	–	No growth	No growth	5	1	No	Resolved
5	F	Staphylococcus schleiferi, S. aureus	Positive	S. aureus	Rothia mucilaginosa, S. aureus	6	2	No	Resolved
6	F	No growth	–	No growth	No growth	5	0	No	Resolved
7	M	S. aureus	Positive	No growth	No growth	7	1	No	Resolved
8	M	Escheria coli	Positive	No growth	No growth	5	0	No	Resolved
9	M	S. aureus	Positive	S. aureus	No growth	7	#	Yes	Catheter removed
10	F	No growth	–	No growth	No growth	5	0	No	Resolved
11	M	No growth	–	No growth	No growth	6	2	Yes	Resolved
12	F	No growth	–	No growth	No growth	6	1	Yes	Resolved
13	F	No growth	–	No growth	No growth	5	0	No	Resolved

Notes:

* Exit site scoring system was used for this scoring.¹⁶ Dash indicates that the sensitivity of gentamicin could not be assessed because there was no growth in culture.

# In this patient, catheter had been removed, therefore, exit site score after treatment could not assessed.

Abbreviations: ESI, exit site infection; M, male; F, female.

SchaeferFKlausGMuller-WiefelDEMehlsOIntermittent versus continuous intraperitoneal glycopeptide/ceftazidime treatment in children with peritoneal dialysis-associated peritonitis. The Mid-European Pediatric Peritoneal Dialysis Study Group (MEPPS)J Am Soc Nephrol19991011361459890319

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