Relapsing peritonitis and taurolidine peritoneal catheter lock: One center experience

Background: Relapsing peritonitis due to the development of a biofilm in the catheter’s lumen remains an important complication of peritoneal dialysis therapy that endangers technique continuity. Taurolidine catheter lock has proven efficient reducing infection rates in permanent hemodialysis cathet...

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Bibliographic Details
Published in:The journal of vascular access 2021-03, Vol.22 (2), p.261-265
Main Authors: Sosa Barrios, R Haridian, Álvarez Nadal, Marta, Burguera Vion, Víctor, Campillo Trapero, Cristina, López Melero, Eva, Fernández Lucas, Milagros, Rivera Gorrín, Maite E
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Anti-Infective Agents - adverse effects
Anti-Infective Agents - therapeutic use
Catheter-Related Infections - microbiology
Catheter-Related Infections - prevention & control
Catheterization - adverse effects
Catheterization - instrumentation
Catheters, Indwelling - adverse effects
Female
Humans
Male
Middle Aged
Peritoneal Dialysis - adverse effects
Peritoneal Dialysis - instrumentation
Peritonitis - microbiology
Peritonitis - prevention & control
Recurrence
Retrospective Studies
Risk Assessment
Risk Factors
Taurine - adverse effects
Taurine - analogs & derivatives
Taurine - therapeutic use
Thiadiazines - adverse effects
Thiadiazines - therapeutic use
Time Factors
Treatment Outcome
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Summary:Background: Relapsing peritonitis due to the development of a biofilm in the catheter’s lumen remains an important complication of peritoneal dialysis therapy that endangers technique continuity. Taurolidine catheter lock has proven efficient reducing infection rates in permanent hemodialysis catheters based on its biocidal activity and biofilm detachment effect. Efficacy evidence on its use in peritoneal dialysis catheters is lacking. Methods: We retrospectively analyzed all relapsing peritonitis episodes from June 2018 until October 2019 in our center. Patients were identified and data were collected from our electronic renal registry and patient’s records. Results: Six patients were identified during the study period. Most patients (66.6%) were on automated peritoneal dialysis and the median duration of peritoneal dialysis before the episode of taurolidine was started was 43.66 ± 29.64 months. Mean taurolidine doses were 10 (range: 9–11) and 83.3% (five patients, with peritonitis caused by Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, and Corynebacterium propinquum) had a favorable response and microbial eradication without relapses after taurolidine treatment. Only one patient relapsed by the same organism (Corynebacterium amycolatum) due to non-adherence to the antibiotic treatment prescribed. None of the patients experienced any relevant adverse events, with only two out of six presenting mild transient abdominal discomfort. Conclusion: We believe that peritoneal catheter taurolidine lock could be considered in cases of relapsing or refractory peritonitis, as it could prevent catheter removal and permanent switch to hemodialysis in selected cases, although literature is scarce and further studies are needed.
ISSN:1129-7298
1724-6032
DOI:10.1177/1129729820937099