{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:24:42Z","timestamp":1787239482359,"version":"build-2736575974"},"reference-count":68,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T00:00:00Z","timestamp":1630972800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ther Apher Dial"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Exit site infection (ESI) is a leading complication of peritoneal dialysis (PD), at an incidence of 0.6 episodes per year in the United States, and a major risk factor for catheter removal and peritonitis. An estimated 20% of all peritonitis cases are preceded by an ESI, with up to 50% of\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    peritonitis associated with ESI. Gram\u2010negative ESIs are less associated with succeeding peritonitis than their gram\u2010positive counterparts, though when present, are associated with a lower peritonitis cure rate. The rate of catheter removal for refractory ESI is relatively highest in ESI due to mycobacteria (up to 40%),\n                    <jats:italic>S. aureus<\/jats:italic>\n                    (35%),\n                    <jats:italic>\n                      P\n                      <jats:styled-content style=\"fixed-case\">seudomonas<\/jats:styled-content>\n                      aeruginosa\n                    <\/jats:italic>\n                    (28%), followed by Corynebacterium, Serratia, and fungi. In review of relevant literature, we found no prophylactic benefit of dressings over nondressings, specific antiseptics over normal saline, or topical honey over topical antibiotic prophylaxis, and thus recommend individualized exit site hygiene. We found topical gentamicin effective for prevention of most ESIs, including gram\u2010negative ESIs, and thus recommend consideration of prophylactic topical gentamicin in areas of high gram\u2010negative peritonitis incidence. With long\u2010term use, observational studies detect up to 25% of gram\u2010positive and 14% of gram\u2010negative ESIs may be mupirocin and gentamicin resistant, respectively. We review empiric and targeted ESI management, including indications for ultrasound, anti\u2010VMRSA, anti\u2010Pseudomonal, and anti\u2010mycobacterial antibiotic use, and catheter removal. We recommend further investigation into the earlier use of second\u2010line treatment agents and the utility of treating post\u2010infectious exit site colonization as avenues to decrease refractory and repeat ESI.\n                  <\/jats:p>","DOI":"10.1111\/1744-9987.13726","type":"journal-article","created":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T06:41:16Z","timestamp":1629960076000},"page":"275-287","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Epidemiology, management, and prevention of exit site infections in peritoneal dialysis patients"],"prefix":"10.1111","volume":"26","author":[{"given":"Moniyka","family":"Sachar","sequence":"first","affiliation":[{"name":"Alpert Medical School of Brown University  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0811-6900","authenticated-orcid":false,"given":"Ankur","family":"Shah","sequence":"additional","affiliation":[{"name":"Alpert Medical School of Brown University  Providence Rhode Island USA"},{"name":"Division of Nephrology Rhode Island Hospital  Providence Rhode Island USA"},{"name":"Providence Veterans Affairs Medical Center  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3747\/pdi.2016.00120"},{"key":"e_1_2_9_3_1","first-page":"230","article-title":"Erythema: does it indicate infection in a peritoneal catheter exit site?","volume":"8","author":"Gonthier D","year":"1992","journal-title":"Adv Perit Dial"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V101136"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0896860820949032"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/089686088800800308"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41100-020-00261-4"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/089686089901900610"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3747\/pdi.2016.00078"},{"key":"e_1_2_9_10_1","doi-asserted-by":"crossref","unstructured":"AuCWH YapDYH ChanJFW YipTPS ChanTM.Exit site infection and peritonitis due to Serratia species in patients receiving peritoneal dialysis: epidemiology and clinical outcomes. 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