Microbiological evaluation of the safety cap on peritoneal dialysis
PDF (Español (España))


Peritoneal dialysis
Safety lock

How to Cite

Mejía García CH, Cano Silva LF, Herrera M, Rodríguez H. Microbiological evaluation of the safety cap on peritoneal dialysis. Rev. Colomb. Nefrol. [Internet]. 2016 Jan. 9 [cited 2022 Jan. 20];2(2):119-30. Available from: https://www.revistanefrologia.org/index.php/rcn/article/view/214


In patients with end-stage renal disease treated with peritoneal dialysis, peritonitis remains as a main cause of complications and therapy loss, even after reducing peritonitis appearance rate. Etiological factors which have been associated are multiple, including clinical conditions of patient, adherence to the clinical protocol of the therapy, socioeconomic status and the system used to deliver fluid to peritoneal cavity. Considering all these factors, we decided to study the adherence to the protocol of connection in dialysis, its microbiological behavior and its association to the safety cap of the previous exchange of peritoneal dialysis system BenY®, in patients who were previously classified according to their adherence to the protocol of connection in dialysis. Patients’ technique of connection to their therapy was assessed through nine key steps and some additional remarks, and then cultures of new and used devices were collected. In our study, there is no evidence of a clinically significant correlation of evaluated devices and peritonitis, compared to other devices designed for the same aim.
PDF (Español (España))


1. Nessim SJ, Bargman JM, Austin PC, Nisenbaum R, Jassal SV. Predictors of Peritonitis in Patients on Peritoneal Dialysis: Results of a Large, Prospective Canadian Database. Clin J Am Soc Nephrol. 2009 Jul;4(7):1195–1200.

2. Kerschbaum J, König P, Rudnicki M. Risk Factors Associated with Peritoneal-Dialysis-Related Peritonitis. International Journal of Nephrology. 2012;2012.

3. Sinnakirouchenan R, Holley JL. Peritoneal dialysis versus hemodialysis: risks, benefits, and access issues. Adv Chronic Kidney Dis. 2011 Nov;18(6):428-32.

4. Li PK, Chow KM. Infectious complications in dialysis--epidemiology and outcomes. Nat Rev Nephrol. 2011 Dec 20;8(2):77-88.

5. Bargman JM.Advances in peritoneal dialysis: a review. Semin Dial. 2012 Sep-Oct;25(5):545-9.

6. Van Esch S, Krediet RT, Stuiljk DG. 32 years' experience of peritoneal dialysis-related peritonitis in a university hospital. Perit Dial Int. 2014 Mar-Apr;34(2):162-70.

7. Hsieh YP, Chang CC, Wang SC, Wen YK, Chiu PF, Yang Y. Predictors for and impact of high peritonitis rate in Taiwanese continuous ambulatory peritoneal dialysis patients. Int Urol Nephrol. 2015 Jan;47(1):183-9.

8. Bilen Y, Cankaya E, Bilen N, Keles M, Erdem F, Uyanik A, et al. Peritonitis incidence was correlated with duration of peritoneal dialysis rather than leptin or neutrophil to lymphocyte (n/l) ratio in peritoneal dialysis patients. J Med. 2014 Oct;46(3):145-50.

9. Van Esch S, van Diepen A, Struijk DG, Krediet RT. The mutual relationship between peritonitis and peritoneal transport. Perit Dial Int. 2014 Nov 13

10. Bekaoui S, Haddiya I, Houti MS, Berkchi FZ, Ezaitouni F, Ouzeddoun N, et al. Infectious peritonitis profile in peritoneal dialysis at Ibn Sina University Hospital: a 6-year data report. Int J Nephrol Renovasc Dis. 2014 Aug 2;7:323-7.

11. Fan X, Huang R, Wang J, Ye H, Guo Q, Yi C, et al. Risk factors for the first episode of peritonitis in Southern Chinese continuous ambulatory peritoneal dialysis patients. PLoS One. 2014 Sep 15;9(9)

12. Rivera-Gorrin M, Teruel-Briones JL, Rodríguez-Mendiola N, Díaz- omínguez M, Ruiz-Roso G, Quereda-Rodríguez- Navarro C. Residual renal function in patients on peritoneal dialysis: effect of peritonitis episodes. Nefrología. 2014 Nov 17;34(6):802-4.

13. Bekaoui S, Haddiya I, Houti MS, Berkchi FZ, Ezaitouni F, Ouzeddoun N, et al. Infectious peritonitis profile in peritoneal dialysis at IbnSina University Hospital: a 6-year data report. Int J of Nephrol Renovacs 2014 Aug 7: 323–327.

14. Warady BA.Meeting the challenges of infection in pediatric peritoneal dialysis. Perit Dial Int. 2012 Jun;32Suppl 2:S31. doi: 10.3747/pdi.2012.00128.

15. Ferian M. Peritonitis and catheter-related infections in peritoneal dialysis. G Ital Nefrol. 2012 Sep-Oct;29 Suppl 56:S56-61.

16. Chao CT, Lee SY, Yang WS, Chen HW, Fang CC, Yen CJ, et al. Peritoneal dialysis peritonitis by anaerobic pathogens: a retrospective case series. BMC Nephrol. 2013 May 24;14:111.

17. Kitterer D, Latus J, Pöhlmann C, Alscher MD, Kimmel M. Microbiological Surveillance of Peritoneal Dialysis Associated Peritonitis: Antimicrobial Susceptibility Profiles of a Referral Center in GERMANY over 32 Years. 0.1371/journal.pone.0135969.

18. Knehtl M, Ekart R, Bevc S, Horvat M, Hojs R. Exit-site infection and acute peritonitis due to peritoneal dialysis catheter rupture. Perit Dial Int. 2015 May-Jun;35(3):362-3.

19. Jiang N, Zhang Z, Fang W, Qian J, Mou S, Ni Z. High Peritoneal Glucose Exposure Is Associated with Increased Incidence of Relapsing and Recurrent Bacterial Peritonitis in Patients Undergoing Peritoneal Dialysis. Blood Purif. 2015;40(1):72-8.

20. Bakkaloglu SA, Warady BA. Difficult peritonitis cases in children undergoing chronic peritoneal dialysis: relapsing, repeat, recurrent and zoonotic episodes. Pediatr Nephrol. 2015 Sep;30(9):1397-406.

21. Nepal HP, Khanal B, Sharma SK, Gyawali N, Jha PK, Paudel R. Peritonitis in a continuous ambulatory peritoneal dialysis patient by two different species of enterococci: A rare finding. Indian J Nephrol. 2014 Sep;24(5):324-6.

22. Kumar KV, Mallikarjuna HM, Gokulnath, Jayanthi S.Fungal peritonitis in continuous ambulatory peritoneal dialysis: The impact of antifungal prophylaxis on patient and technique outcomes. Indian J Nephrol. 2014 Sep;24(5):297-301.

23. Hisamichi M, Yokoyama T, Yazawa M, Kaneshiro N, Sakurada T, Konno Y, et al. A rare case of peritoneal dialysis-related peritonitis caused by goldfish water tankderived Aeromonashydrophila. Clin Nephrol. 2015 Jul;84(1):50-4.

24. Bieber SD, Anderson AE, Mehrotra R. Diagnostic testing for peritonitis in patients undergoing peritoneal dialysis. Semin Dial. 2014 Nov-Dec;27(6):602-6

25. Saxena AB. Recent advances in the management of peritoneal dialysis patients. F1000 Prime Rep. 2015 May 1;7:57.

26. Crabtree JH, Siddiqi RA. Simultaneous catheter replacement for infectious and mechanical complications without interruption of peritoneal dialysis. Perit Dial Int. 2015 Oct 1(2):173-174.

27. Kataria A, Saad E. Severe peritonitis caused by Citrobacterfreundii and successful treatment with double antibiotic coverage. Indian J Nephrol. 2015 Mar-Apr;25(2):117-8.

28. Ditsawanon P, Aramwit P. Preserving the peritoneal membrane in long-term peritoneal dialysis patients. J Clin Pharm Ther. 2015 Aug 17 (40) 508 – 516.

29. Van Esch S, Krediet RT, Struijk DG. Prognostic factors for peritonitis outcome. Contrib Nephrol. 2012;178:264-70.

30. Lambie M, Chess J, Donovan KL, Kim YL, Do JY, Lee HB, et al. Independent effects of systemic and peritoneal inflammation on peritoneal dialysis survival. Global Fluid Study Investigators. J Am Soc Nephrol. 2013 Dec;24(12):2071-80.

31. Wang Z, Jiang L, Feng S, Yang L, Jiang S, Zhan Z, et al. Early peritonitis is an independent risk factor for mortality in elderly peritoneal dialysis patients. Kidney Blood Press Res. 2015;40(3):298-305.

32. Marley JV, Moore S, Fitzclarence C, Warr K, Atkinson D. Peritoneal dialysis outcomes of Indigenous Australian patients of remote Kimberley origin. Aust J Rural Health. 2014 Jun;22(3):101-8.

33. Hsieh YP, Chang CC, Wang SC, Wen YK, Chiu PF, Yang Y. Predictors for and impact of high peritonitis rate in Taiwanese continuous ambulatory peritoneal dialysis patients. Int Urol Nephrol. 2015 Jan;47(1):183-9.

34. Kim Y, Song YR, Kim JK, Kim HJ, Kim S, Kim SG. Use of a new connector decreases peritoneal dialysis-related peritonitis. Perit dial Int 2014 Feb; 34 (1):128-30.

35. Di Bonaventura G, Cerasoli P, Pompilio A, Arrizza F, Di Liberato L, Stingone A, et al. In vitro microbiology studies on a new peritoneal dialysis connector. Perit Dial Int. 2012 Sep-Oct;32(5):552-7.

36. Daly C, Cody JD, Khan I, Rabindranath KS, Vale L, Wallace SA. Double bag or Y-set versus standard transfer sys- tems for continuous ambulatory peritoneal dialysis in end-stage kidney disease. Cochrane Database Syst Rev. 2014 Aug 13;(8):126-129.

37. Piraino B. Approaches to preventing peritonitis based on organism- pecific rates. Perit Dial Int. 2011 Nov-Dec;31(6):636-8.

38. Velioglu A, Asicioglu E, Ari E, Arikan H, Tuglular S, Ozener C. Prevention of peritonitis in newly placed peritoneal dialysis catheters: efficacy of oral prophylaxis with cefuroxime axetil- a preliminary study. Minerva Urol Nefrol. 2015 Feb 12 (6):145-147.

39. Thokhonelidze I, Maglakelidze N, Sarishvili N, Kasradze T, Dalakishvili K. Single center experience in successful prevention of exit-site infection in patients on peritoneal dialysis. Georgian Med News. 2015 Apr;(241):54-8.

40. Campbell DJ, Johnson DW, Mudge DW, Gallagher MP, Craig JC. Prevention of peritoneal dialysis-related infections.Nephrol Dial Transplant. 2015 Sep;30(9):1461-72.

41. Wong C, Luk IW, Ip M, You JH. Prevention of gram-positive infections 42. Carney EF. Dialysis: Prevention of peritoneal-dialysis-related infections-antibacterial honey might not be the solution. Nat Rev Nephrol. 2013 Dec;9(12):693.

43 Piraino B. Prevention of peritonitis in peritoneal dialysis. Contrib Nephrol. 2012;178:246-50.

44. Johnson DW, Badve SV, Pascoe EM, Beller E, Cass A, Clark C, et al. Antibacterial honey for the prevention of peri- toneal-dialysis-related infections (HONEYPOT): a randomised trial. HONEYPOT Study Collaborative Group. Ancet Infect Dis. 2014; Jan; 14(1):23-30.

45. Wong C, Luk IW, Ip M, You JH. Prevention of gram-positive infections in peritoneal dialysis patients in Hong Kong: a cost-effectiveness analysis. Am J Infect Control. 2014 Apr;42(4):412-6.

46. Carballo-Monreal MR, Ortega-Ramírez N, Lizárraga-Zambrano EC, Díaz-Palafox J. Adherencia individual y familiar al tratamiento de diálisis peritoneal ambulatoria continua. Rev Enferm Inst Mex Seguro Soc. 2008;16(1):13-18

47. Sayed SA, Abu-Aisha H, Ahmed ME, Elamin S. Effect of the patient's knowledge on peritonitis rates in peritoneal dialysis. Perit Dial Int. 2013 Jul-Aug;33(4):362-6.

48. Cho Y, Johnson DW. Peritoneal dialysis-related peritonitis: towards improving evidence, practices, and outcomes. Am J Kidney dis. 2014 Aug; 64(2):278 – 89.

49. Gadola L, Poggi C, Poggio M, Sáez L, Ferrari A, Romero J, et al. Using a multidisciplinary training program to reduce peritonitis in peritoneal dialysis patients. Perit Dial Int. 2013 Jan-Feb;33(1):38-45.

50. Campbell DJ, Brown FG, Craig JC, Gallagher MP, Johnson DW, Kirkland GS, et al. Assessment of current practice and barriers to antimicrobial prophylaxis in peritoneal dialysis patients. Nephrol Dial Transplant. 2015 Apr 22(3):25-27.

51. Schaepe C, Bergjan M. Educational interventions in peritoneal dialysis: a narrative review of the literature. Int J Nurs Stud. 2015 Apr;52(4):882-98.

52. Figueiredo AE, Moraes TP, Bernardini J, Poli-de-Figueiredo CE, Barretti P, Olandoski M, et al. Impact of patient training patterns on peritonitis rates in a large national cohort study. BRAZPD Investigators. Nephrol Dial Transplant. 2015 Jan;30(1):137-42.
No national or foreign publication may partially or totally reproduce or translate Revista Colombiana de Nefrología articles or abstracts without prior written permission from the journal’s Editorial Board.


Download data is not yet available.