THE EFFECT OF EXIT-SITE ANTIBACTERIAL HONEY VERSUS NASAL MUPIROCIN PROPHYLAXIS ON THE MICROBIOLOGY AND OUTCOMES OF PERITONEAL DIALYSIS-ASSOCIATED PERITONITIS AND EXIT-SITE INFECTIONS: A SUB-STUDY OF THE HONEYPOT TRIAL
机构:[1]Australasian Kidney Trials Network, University of Queensland, Brisbane, Australia[2]Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China大德路总院肾内科大德路总院肾内科广东省中医院[3]Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia[4]Centre for Research in Evidence-Based Practice, Bond University, Gold Coast, Australia[5]Menzies School of Health Research, Darwin, Australia[6]Department of Nephrology, Nambour Hospital, Nambour, Australia[7]Department of Renal Medicine, North Shore Hospital, Auckland, New Zealand[8]Child & Adolescent Renal Service, Royal Children’s and Mater Children’s Hospitals, Brisbane, Australia[9]Infection Management Services, Princess Alexandra Hospital, Brisbane, Australia[10]Department of Nephrology, Royal Prince Alfred Hospital, Sydney, Australia
Background: The HONEYPOT study recently reported that daily exit-site application of antibacterial honey was not superior to nasal mupirocin prophylaxis for preventing overall peritoneal dialysis (PD)-related infection. This paper reports a secondary outcome analysis of the HONEYPOT study with respect to exit-site infection (ESI) and peritonitis microbiology, infectious hospitalization and technique failure. Methods: A total of 371 PD patients were randomized to daily exit-site application of antibacterial honey plus usual exit-site care (N = 186) or intranasal mupirocin prophylaxis (in nasal Staphylococcus aureus carriers only) plus usual exit-site care (control, N = 185). Groups were compared on rates of organism-specific ESI and peritonitis, peritonitisand infection-associated hospitalization, and technique failure (PD withdrawal). Results: The mean peritonitis rates in the honey and control groups were 0.41 (95% confidence interval [CI] 0.32-0.50) and 0.41 (95% CI 0.33-0.49) episodes per patient-year, respectively (incidence rate ratio [IRR] 1.01, 95% CI 0.75-1.35). When specific causative organisms were examined, no differences were observed between the groups for gram-positive (IRR 0.99, 95% CI 0.66-1.49), gram-negative (IRR 0.71, 95% CI 0.39-1.29), culturenegative (IRR 2.01, 95% CI 0.91-4.42), or polymicrobial peritonitis (IRR 1.08, 95% CI 0.36-3.20). Exit-site infection rates were 0.37 (95% CI 0.28-0.45) and 0.33 (95% CI 0.26-0.40) episodes per patient-year for the honey and control groups, respectively (IRR 1.12, 95% CI 0.81-1.53). No significant differences were observed between the groups for gram-positive (IRR 1.10, 95% CI 0.70-1.72), gram-negative (IRR: 0.85, 95% CI 0.46-1.58), culturenegative (IRR 1.88, 95% CI 0.67-5.29), or polymicrobial ESI (IRR 1.00, 95% CI 0.40-2.54). Times to first peritonitis-associated and first infection-associated hospitalization were similar in the honey and control groups. The rates of technique failure (PD withdrawal) due to PD-related infection were not significantly different between the groups. Conclusion: Compared with standard nasal mupirocin prophylaxis, daily topical exit-site application of antibacterial honey resulted in comparable rates of organism-specific peritonitis and ESI, infection-associated hospitalization, and infection-associated technique failure in PD patients.
基金:
Baxter Healthcare (McGaw Park, IL, USA); Queensland Government (Smart State Health Grant); Gambro (Baulkham Hills, NSW, Australia); Baxter Healthcare (Renal Discoveries Extramural Grant Program)
第一作者机构:[1]Australasian Kidney Trials Network, University of Queensland, Brisbane, Australia[2]Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
通讯机构:[*1]Department of Nephrology, Level 2, ARTS Building, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane, Qld 4102, Australia.
推荐引用方式(GB/T 7714):
Zhang Lei,Badve Sunil V.,Pascoe Elaine M.,et al.THE EFFECT OF EXIT-SITE ANTIBACTERIAL HONEY VERSUS NASAL MUPIROCIN PROPHYLAXIS ON THE MICROBIOLOGY AND OUTCOMES OF PERITONEAL DIALYSIS-ASSOCIATED PERITONITIS AND EXIT-SITE INFECTIONS: A SUB-STUDY OF THE HONEYPOT TRIAL[J].PERITONEAL DIALYSIS INTERNATIONAL.2015,35(7):712-721.doi:10.3747/pdi.2014.00206.
APA:
Zhang, Lei,Badve, Sunil V.,Pascoe, Elaine M.,Beller, Elaine,Cass, Alan...&for the HONEYPOT Study Collaborative Group.(2015).THE EFFECT OF EXIT-SITE ANTIBACTERIAL HONEY VERSUS NASAL MUPIROCIN PROPHYLAXIS ON THE MICROBIOLOGY AND OUTCOMES OF PERITONEAL DIALYSIS-ASSOCIATED PERITONITIS AND EXIT-SITE INFECTIONS: A SUB-STUDY OF THE HONEYPOT TRIAL.PERITONEAL DIALYSIS INTERNATIONAL,35,(7)
MLA:
Zhang, Lei,et al."THE EFFECT OF EXIT-SITE ANTIBACTERIAL HONEY VERSUS NASAL MUPIROCIN PROPHYLAXIS ON THE MICROBIOLOGY AND OUTCOMES OF PERITONEAL DIALYSIS-ASSOCIATED PERITONITIS AND EXIT-SITE INFECTIONS: A SUB-STUDY OF THE HONEYPOT TRIAL".PERITONEAL DIALYSIS INTERNATIONAL 35..7(2015):712-721