PD Tunnel Infection Catheter Removal — ESENeph MCQ

Correct answer: E — Remove the catheter for replacement at a new site

The best answer is “Remove the catheter for replacement at a new site”. ISPD allows removal with simultaneous reinsertion at a new site under antibiotic coverage for selected refractory exit-site or tunnel infection. Deep-cuff involvement or concurrent peritonitis would instead argue against simultaneous replacement. “Continue the unchanged antibiotic regimen indefinitely with the catheter in place” is less appropriate because refractory tunnel infection is unlikely to be eradicated without source control “Insert the replacement catheter through the infected tunnel” is less appropriate because a new catheter, if inserted simultaneously, is placed at a new site away from infection “Perform simultaneous replacement even if same-organism peritonitis develops” is less appropriate because concurrent peritonitis is a reason to avoid simultaneous removal and reinsertion “Stop antibiotics immediately after catheter removal” is less appropriate because effective antimicrobial coverage continues through the source-control strategy

Reference: ISPD catheter-related infection recommendations: 2023 update: https://pubmed.ncbi.nlm.nih.gov/37232412/