Question about PD infection frequency

[PaulBC]

Does anyone have a rough idea of the most likely reasons for developing an infection with PD?

I feel that unless you make a mistake during setup, there is minimal risk of getting an infection directly though the catheter opening. Aside from using masks and washing hands, the connectors start out capped and only need to touch each other. The catheter cap is soaked in iodine inside. Even the fact that the first part of the process is draining makes me feel confident that the untouched connection, sanitized with iodine is going to be flushed away from the catheter opening. The germs don't have a chance, right? This looks like a very effective system provided you are careful.

But infections do happen and now I wonder how. I think the least controlled part is the exit site rather than the catheter opening. I also understand that soaking in warm or dirty water is going to present a risk of infection. Is that the main cause? Anything else?

[cassandra]

My first P infection was down to me (Careless connecting) but the next two were caused by the Peritonitis  having infected my cerebral shunt (to my heart), not the right antibiotics, and reinfecting peritoneum by infected cerebral shunt.

[jcanavera]

My wife's PD nurse says it's very infrequent.  He says the major cause he has seen is from forgetting to put on the masks.  Technique in keeping your hands clean and not touching the open ends of the tubing with your hands or furniture holding the bags and cycler are important safe guards.  If your hand/finger  dexterity isn't good, and you don't have sanitary hands, your chance of contamination is increased.  You really have to keep your hands in mind once you sanitize them and start to connect the bags to the tube set and yourself.  I do all the connections for my wife which gives me more dexterity than if she was doing this herself.

Jack