Preventing infections in a dialysis unit

Abstract

Acute bacterial infections are common place in the severely immune compromised patients in advanced renal failure needing dialysis. Peritoneal and haemodialysis are both invasive procedures and contamination can lead to life threatening peritonitis and septicaemia (from vascular access infection)respectively. In this connection peritoneal dialysis even in reputed centres in associated with a high incidence of multiple drug resistant hospital acquired organisms. Forty patients undergoing Acute Peritoneal Dialysis who were consecutively dialysed by the University Medical Unit were analysed. Twelve of the forty patients had serious peritonitis developing and four of these patients deid of uncontrolled septicaemia. Since infection plays a very significant role in morbidity and mortality patterns in a dialysis unit, expensive last line antibiotics add greatly to the already high cost of dialysis care. We recommend that attention be given to the following factors. a) Peritoneal dialysis catheter insertion. b) Aseptic environment fro dialysis. c) Duration of dialysis and duration of catheter stay. d) Additions to dialysis fluid. e) Bacteriological vigilance