PD catheter infection

[winefred]

I have a situation I was hoping someone has gone through the same thing. I had my first pd cath put in in November 29 2012. Toward the end of my training, the last few days my exit site had a green/yellow discharge and the pd cath was leaking. My neph put me on two different antibiotics for 14 days each and we stopped training. Went back after I was done with antibiotics and the infection was still there. My neph said the infection was in the cath itself and it had to come out. So just two days ago I had surgery to remove the cath. The surgeon had me do an IV antibiotic before I went home. I go back to the surgeon on the 9th and hopefully we will schedule another surgery to put in a new cath. I am so scared that I am going to get an infection in the new cath. No one can tell me how it got there since I followed the rules exactly as I should have. I wasnt able to shower for 6 weeks, and i even waited that hole time. Has anyone had an infection in the catheter?  How did it turn out? Is there something I should be doing that I don't know about?  Any input or suggestions would be so appreciated.

[MaryD]

I had peritonitis which wouldn't go away (three times) and eventually it was decided that my catheter had to be replaced.  I was loaded up with antibiotics and catheter-less for 4 weeks before they got the replacement in and working.  That was about a year ago and PD is going fine to date

[adairpete]

I haven't had one personally, but someone at the clinic did.  She got a fungal infection and had to have the catheter removed.  She was on antibiotics and hemo until it cleared and she had a new one put in and went back to PD. Keep doing the preventive measures, though, but these things happen.  I wouldn't stress too much on where it came from and if you could've prevent it-bacteria are everywhere and take advantage of wherever they can to grow and multiply.

[Darthvadar]

Hi Winefred...

I think I can be some small help and reassurance on this one...

I'm caring for my mum who's on PD... I do all of her dialysis and other care needs because she also has significant Parkinson's Disease... She has had three bouts of Peretonitis, and after about ten days in hosp. on each occasion, got over them...

Now the cathether (known here as a TenchKoff)...

Mum's cath always leaked from the time it went in around the end of 2008... Always a bit of oooze on the dressing at every change... Kept being told that it wasn't a problem, (Yeah, right!)... It was always clear fluid, but I felt it wasn't 'quite right'... But as Mum was healthier and happier on PD, I didn't push it...Then at the end of last July, the exit site looked red, and the ooze changed colour... Took her to the hosp. to see the Neph. team... They swabbed it, and put her on two antibiotics.... It would settle down, and then flare up as soon as she finished the antibiotic... Back to the Neph.,  Back on antibiotics, flare-up again, etc... Visits to the hospital???... We were up and down like a jockey's doo-dahs!... So by Sept 10th, she'd been on four courses of antibiotics, and there was still a dirty looking ooze and an odour developed  (think rotten meat!)... The decision was taken to remove the TenchKoff, put a line (PermaCath) into her chest to deliver short-term haemo, let everything heal for a few weeks, and then replace the TenchKoff...

This was done, and they discovered a load of pus in the tunnel created by the TenchKoff... She was on antibiotics for about a month, had the Community Nurse calling in three times a week to pack and dress the wound, and had haemodialysis... Due to a combination of delays, she didn't have a new TenchKoff fitted until mid December, and a few other delays meant she wasn't back on PD until the end of January... But to be honest, I think this delay was the best thing that EVER happened...

Remember my saying that there had always been leaking from the TenchKoff site???... I really believe tha the first one was used far too soon (about ten days after it was fitted), and I don't think that there was enough healing time given for there to be a 'good seal' created around the TenchKoff... This time, the six weeks delay (while we regarded it as the greatest PITA at the time), was the very best thing that could have happened... Mum got enough time to heal, a good seal has developed around the TenchKoff, and it's working perfectly...

With her old TenchKoff, each exchange was taking about 45 minutes... Now it's never taken more than 25 minutes!... Old fluid flows out easily, and fresh fluid flows in easily... And remember I mentioned that there was always a bit of oooze on the dressings with the old TenchKoff???... I change Mum's dressings every two days, and since this TenchKoff went in, there has NEVER been a single drop of oooze on a dressing.... All dressings have come off totally clean....

So I suppose what I'm saying is, don't lose hope, it will work out... And don't let them put you back on PD until YOU feel that your new TenchKoff site is completely healed... An extra little while on Haemo will be a great investment in your future on PD... Your healthcare provider would FAR rather you go back on PD as soon as possible because it's cheaper, and I'm pretty sure you'd rather be on PD, but be patient for a few weeks... Getting a good seal, a free-flowing TenchKoff, and peace of mind are WELL worth waiting for!....

Hope this is of help to you, and may I wish you all the very best... Oh, and chin Up... It WILL get better....

Feel free to contact me if I can be of any assistance...

God bless....

Darth...

[winefred]

Thanks for all your responses. I too have parkinsons and had a transplant 29 years ago, which is now failing. i am not on any dialysis yet. my neph wanted me to get the cath put in well in advance so i would be ready for PD when my symptoms started to get worse. I finally had a new cath put in on Monday the 20th, my surgeon and I decided on a presternal cath which he seems to think I am a good candidate for. I go in Tuesday to have it checked and I will find out then when he wants me to start. I will make sure they don't start me until I am completely healed. Thanks for all your advise, it helped me a lot.

[amanda100wilson]

Winifred, I am no longer on PD but I would ,have loved a pre-sternal catheter as I think that it would be much more comfortable.  It is possible that how you cared for the catheter had no role in the infection since a lot of infections are aqcuired at the time of surgery.  The leaking may have occured because the imfection i tefered with the integrity of,the skin and tissue around the catheter.  Good luck with your next one.