Kidney dialysis patients how to avoid infection?

Kidney dialysis patients how to avoid infection?
Over the years, hemodialysis (HD) and peritoneal dialysis (PD) patients has been considered for vaccination reduced the response, as demonstrated to produce such as hepatitis B, pneumococcus, influenza A H1N1 influenza, tetanus toxoid vaccine serum protective antibodies.

Dialysis patients with chronic pulmonary infection mortality rate is 14 to 16 times the general population, where more than half of lower respiratory tract infections caused by Streptococcus pneumoniae.

According to reports, in dialysis patients with pneumonia, lower respiratory tract infection also increases the risk of cardiovascular events 3.02 ratio.

Compared with PD patients, the higher the risk of HD patients with pulmonary infection, which may increase lung water during dialysis more information.

In addition, HD patients in dialysis centers often travel together, and together we waited during dialysis, which increases the risk of respiratory pathogen transmission, while the PD is a "home" treatment.

Second, measures to reduce the prevalence of hemodialysis patients

HD patients at risk of infection in the previous six-month high.

Due to very different clinical practice, it requires the use of a retrospective analysis of prevalence of these infection prevention center. For example, the cannula can be in the operating room, interventional radiology room or ward preparation chamber after skin preparation carried out, the use of prophylactic antibiotics (including antibiotics of choice, dose and time of administration), S. aureus eradication therapy and re-intubation exit care.

Central venous dialysis catheters choice may also influence the risk of infection, not only whether there is a tunnel and with a cuff, the effect will be different in different designs (eg dual chamber with two single lumen catheters, biological materials, the smoothness of the surface of the catheter, of different sizes, the composition of the catheter cuff, heparin closed, antiseptic, antibiotic, silver and bismuth, etc.).

Therefore, catheter care varies due to different centers, which reflects whether adherence to aseptic technique when connecting and disconnecting conduit, the conduit outlet conduit local care and sealing in.

Since the operation to reduce the risk of infection for each clinical care guidelines are in need of financial costs for patients and health care foundation, it determines what actions can effectively reduce the risk of infection, which the most effective, is very important.

Although the implementation of clinical care guidelines for infection prevention in HD patients to reduce the incidence of catheter-related bacteremia, similar methods of care did not significantly reduce the risk of PD patients with peritonitis occurred in Europe.

Hong Kong and Japan, incidence of peritonitis has always been lower than Northern Europe, North America and Australia.

Although there are differences of climate, but peritonitis similar pathogens, mainly Gram-positive skin commensal bacteria, followed by Staphylococcus aureus, which indicates the difference between skin microbes is not significant.

Dietary intake may vary, and changes in diet, such as protein-rich soy diet rich in dietary resistant starch from plant polysaccharides and can be changed gastrointestinal microflora.

Increased intestinal mucosal permeability and bacterial translocation is the most common cause of intestinal gram-negative bacterial peritonitis occurred.

Because fluid intake limits and to reduce the development of phosphorus and potassium intake diet, risk elderly patients with HD and PD diverticular disease have increased.

It will change the intestinal microflora innate and adaptive immunity, which have an impact on the distal portion of the intestine. The combination of these effects may also increase the risk of skin bacteria metastatic peritonitis occurred.

On the other hand, the use of a neutral pH value and low glucose degradation products in peritoneal dialysis solution did not reduce the incidence of peritonitis, which indicate a change in the peritoneal dialysis fluid components without any significant effect on the gut microflora and intestinal permeability.


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