PDF(Pubmed)
Abstract：
BACKGROUND: Exit-site infection (ESI) is a common recurring complication in patients undergoing peritoneal dialysis (PD). Sucrose and povidone-iodine (SPI) mixtures, antimicrobial ointments that promote wound healing, have been used for the treatment of ulcers and burns, but their efficacy in exit-site care is still unclear.
METHODS: This single-center retrospective observational study included patients who underwent PD between May 2010 and June 2022 and presented with episodes of ESI. Patients were divided into SPI and non-SPI groups and followed up from initial ESI onset until PD cessation, death, transfer to another facility, or June 2023.
RESULTS: Among the 82 patients (mean age 62, [54-72] years), 23 were treated with SPI. The median follow-up duration was 39 months (range, 14-64), with an overall ESI incidence of 0.70 episodes per patient-year. Additionally, 43.1% of second and 25.6% of third ESI were caused by the same pathogen as the first. The log-rank test demonstrated significantly better second and third ESI-free survival in the SPI group than that in the non-SPI group (p < 0.01 and p < 0.01, respectively). In a Cox regression analysis, adjusting for potential confounders, SPI use was a significant predictor of decreased second and third ESI episodes (hazard ratio [HR], 0.22; 95% confidence interval [CI], 0.10-0.52 and HR, 0.22; 95%CI, 0.07-0.73, respectively).
CONCLUSIONS: Our results showed that the use of SPI may be a promising option for preventing the incidence of ESI in patients with PD.
BACKGROUND: This study was approved by the Keio University School of Medicine Ethics Committee (approval number 20231078) on August 28, 2023. Retrospectively registered.
METHODS: This single-center retrospective observational study included patients who underwent PD between May 2010 and June 2022 and presented with episodes of ESI. Patients were divided into SPI and non-SPI groups and followed up from initial ESI onset until PD cessation, death, transfer to another facility, or June 2023.
RESULTS: Among the 82 patients (mean age 62, [54-72] years), 23 were treated with SPI. The median follow-up duration was 39 months (range, 14-64), with an overall ESI incidence of 0.70 episodes per patient-year. Additionally, 43.1% of second and 25.6% of third ESI were caused by the same pathogen as the first. The log-rank test demonstrated significantly better second and third ESI-free survival in the SPI group than that in the non-SPI group (p < 0.01 and p < 0.01, respectively). In a Cox regression analysis, adjusting for potential confounders, SPI use was a significant predictor of decreased second and third ESI episodes (hazard ratio [HR], 0.22; 95% confidence interval [CI], 0.10-0.52 and HR, 0.22; 95%CI, 0.07-0.73, respectively).
CONCLUSIONS: Our results showed that the use of SPI may be a promising option for preventing the incidence of ESI in patients with PD.
BACKGROUND: This study was approved by the Keio University School of Medicine Ethics Committee (approval number 20231078) on August 28, 2023. Retrospectively registered.
摘要：
背景：出口部位感染（ESI）是腹膜透析（PD）患者常见的复发性并发症。蔗糖和聚维酮碘（SPI）混合物，促进伤口愈合的抗菌软膏，已经被用于治疗溃疡和烧伤，但其在出院治疗中的疗效尚不清楚.
方法：这项单中心回顾性观察性研究包括2010年5月至2022年6月接受PD并出现ESI发作的患者。患者分为SPI组和非SPI组，从最初的ESI发作到PD停止进行随访，死亡,转移到另一个设施，或2023年6月。
结果：在82名患者（平均年龄62，[54-72]岁）中，23用SPI处理。中位随访时间为39个月(范围,14-64），ESI总发病率为每患者年0.70次。此外,第二个ESI的43.1％和第三个ESI的25.6％是由与第一个相同的病原体引起的。对数秩检验表明，SPI组的第二次和第三次无ESI生存率明显优于非SPI组（分别为p<0.01和p<0.01）。在Cox回归分析中，调整潜在的混杂因素，SPI使用是第二次和第三次ESI发作减少的重要预测因子(风险比[HR]，0.22；95%置信区间[CI]，0.10-0.52和HR，0.22；95CI，分别为0.07-0.73）。
结论：我们的结果表明，使用SPI可能是预防PD患者ESI发生率的有希望的选择。
背景：这项研究于2023年8月28日获得庆应大学医学院伦理委员会（批准号20231078）的批准。追溯登记。
方法：这项单中心回顾性观察性研究包括2010年5月至2022年6月接受PD并出现ESI发作的患者。患者分为SPI组和非SPI组，从最初的ESI发作到PD停止进行随访，死亡,转移到另一个设施，或2023年6月。
结果：在82名患者（平均年龄62，[54-72]岁）中，23用SPI处理。中位随访时间为39个月(范围,14-64），ESI总发病率为每患者年0.70次。此外,第二个ESI的43.1％和第三个ESI的25.6％是由与第一个相同的病原体引起的。对数秩检验表明，SPI组的第二次和第三次无ESI生存率明显优于非SPI组（分别为p<0.01和p<0.01）。在Cox回归分析中，调整潜在的混杂因素，SPI使用是第二次和第三次ESI发作减少的重要预测因子(风险比[HR]，0.22；95%置信区间[CI]，0.10-0.52和HR，0.22；95CI，分别为0.07-0.73）。
结论：我们的结果表明，使用SPI可能是预防PD患者ESI发生率的有希望的选择。
背景：这项研究于2023年8月28日获得庆应大学医学院伦理委员会（批准号20231078）的批准。追溯登记。
