Exit‐site and catheter‐related infections in peritoneal dialysis: Problems and progress
Bibliographic record
Abstract
SUMMARY: Silastic peritoneal catheters are used routinely for peritoneal access in peritoneal dialysis (PD) because they are biocompatible. Catheter insertions are usually succeeded by bacterial adhesion and subsequent colonization of the catheter exit site. Despite the reduction in the proportion of peritonitis due to touch contamination, exit‐site and catheter‐related infections, particularly those caused by Staphylococcus aureus, remain the major cause of catheter loss and technique failure in PD. The peritonitis rate in the global PD population is steadily declining, but as the number of patients on PD increases by about 10% per year the stakes in infection control become greater, and one is forced to consider new options that will reduce the PD patient drop‐out rate. Three areas of promising advances in the prevention of exit‐site and catheter‐related infections are reviewed in this paper: (i) the use of prophylactic antibiotics to eliminate the nasal carriage of Staph. aureus and to reduce exit‐site infections; (ii) the Moncrief–Popovich catheter and implantation technique which reduces bacterial colonization of the catheter exit tunnel; (iii) new catheter implants composed in part of rigid biomaterials with antibacterial properties. This last category includes the silver‐coated silastic PD catheter, significant not only because it has great potential as a replacement for the silastic catheter, but also because it is a reminder that caution must be exercised before fully embracing new treatment options.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.003 | 0.006 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".