Potential clinical value of catheters impregnated with antimicrobials for the prevention of infections associated with peritoneal dialysis.

IF 2.9 3区 医学 Q3 ENGINEERING, BIOMEDICAL
Expert Review of Medical Devices Pub Date : 2023-06-01 Epub Date: 2023-05-03 DOI:10.1080/17434440.2023.2205587
Hari Dukka, Maarten W Taal, Roger Bayston
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引用次数: 0

Abstract

Introduction: Peritoneal dialysis (PD) is a widely used dialysis modality, which offers the advantage of being a home therapy but is associated with a risk of potentially serious infections, including exit site infection, catheter tunnel infection, and peritonitis that may result in morbidity, technique failure, and increased mortality. Catheters impregnated with antimicrobials hold promise as a novel technique to reduce PD associated infections.

Areas covered: We describe PD modalities, catheters, technique, complications, and the microbiology of associated infections, as well as standard measures to reduce the risk of infection. A novel technique for the impregnation of silicone devices with antimicrobial agents has been used to produce antimicrobial impregnated ventricular shunt catheters with proven clinical efficacy that have now been adopted as the standard of care to reduce neurosurgical infections. Using the same technology, we have developed PD and urinary catheters impregnated with sparfloxacin, triclosan, and rifampicin. Safety and tolerability have been demonstrated in urinary catheters, and a similar study is planned in PD catheters.

Expert opinion: Catheters impregnated with antimicrobials offer a simple technique to reduce PD associated infections and thereby enable more people to enjoy the advantages of PD. Clinical trials are needed to establish efficacy.

浸渍抗菌剂的导管在预防腹膜透析相关感染方面的潜在临床价值。
导言:腹膜透析(PD)是一种广泛使用的透析方式,它具有居家治疗的优势,但也存在潜在的严重感染风险,包括出口部位感染、导管隧道感染和腹膜炎,可能导致发病率、技术失败和死亡率上升。浸渍抗菌剂的导管有望成为减少腹膜透析相关感染的新技术:我们介绍了腹腔穿刺方式、导管、技术、并发症、相关感染的微生物学以及降低感染风险的标准措施。用抗菌剂浸渍硅胶装置的新技术已用于生产抗菌剂浸渍的脑室分流导管,其临床疗效已得到证实,现已被作为减少神经外科感染的标准护理方法。利用同样的技术,我们开发出了浸渍有司帕沙星、三氯生和利福平的腹腔分流导管和泌尿导管。导尿管的安全性和耐受性已得到证实,我们还计划对腹腔镜导尿管进行类似的研究:专家意见:浸渍抗菌剂的导管提供了一种简单的技术,可减少与腹腔穿刺相关的感染,从而让更多人享受到腹腔穿刺的好处。需要进行临床试验以确定疗效。
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来源期刊
Expert Review of Medical Devices
Expert Review of Medical Devices 医学-工程:生物医学
CiteScore
5.90
自引率
3.20%
发文量
69
审稿时长
6-12 weeks
期刊介绍: The journal serves the device research community by providing a comprehensive body of high-quality information from leading experts, all subject to rigorous peer review. The Expert Review format is specially structured to optimize the value of the information to reader. Comprehensive coverage by each author in a key area of research or clinical practice is augmented by the following sections: Expert commentary - a personal view on the most effective or promising strategies Five-year view - a clear perspective of future prospects within a realistic timescale Key issues - an executive summary cutting to the author''s most critical points In addition to the Review program, each issue also features Medical Device Profiles - objective assessments of specific devices in development or clinical use to help inform clinical practice. There are also Perspectives - overviews highlighting areas of current debate and controversy, together with reports from the conference scene and invited Editorials.
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