Invited Commentary

  • Lori L. Burrows


This chapter describes the basic principles to be followed when the removal of a medical device is contemplated. The use of medical devices of increasing levels of complexity and with a range of exposure to nonsterile areas or exit sites has risen exponentially in the past several decades. Regardless of site, infection remains the major complicating factor in medical device usage. While scrupulously introduced, totally implanted devices are less prone to infection, when infection occurs, it has much more serious repercussions. The authors correctly advise that the decision to remove a device must be balanced with the effect of its loss on the health of the patient, but the golden rule remains “If in doubt, take it out.”


Peritoneal Dialysis Patient Exit Site Peritoneal Dialysis Catheter Device Removal Device Infection 
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  1. 1.
    Costerton JW, Stewart PS, Greenberg EP (1999) Bacterial biofilms: a common cause of persistent infections. Science 284:1318–1322PubMedCrossRefGoogle Scholar
  2. 2.
    Davey ME, O'Toole G A (2000) Microbial biofilms: from ecology to molecular genetics. Microbiol Mol Biol Rev 64:847–867PubMedCrossRefGoogle Scholar
  3. 3.
    Doyle RJ (1999) Biofilms. Methods Enzymol 6:310Google Scholar
  4. 4.
    Holzheimer RG, Dralle H (2001) Antibiotic therapy in intra-abdominal infections — a review on randomised clinical trials. Eur J Med Res 6:277–291PubMedGoogle Scholar
  5. 5.
    Relman DA (1999) The search for unrecognized pathogens. Science 284:1308–1310PubMedCrossRefGoogle Scholar
  6. 6.
    Wagar EA (1996) Direct hybridization and amplification applications for the diagnosis of infectious diseases. J Clin Lab Anal 10:312–325PubMedCrossRefGoogle Scholar
  7. 7.
    Wagar EA (1996) Defining the unknown: molecular methods for finding new microbes. J Clin Lab Anal 10:331–334PubMedCrossRefGoogle Scholar
  8. 8.
    Fredricks DN, Relman DA (1999) Application of polymerase chain reaction to the diagnosis of infectious diseases. Clin Infect Dis 29:475–488PubMedCrossRefGoogle Scholar
  9. 9.
    Burrows LL, Khoury AE (1999) Issues surrounding the prevention and management of device-related infections. World J Urol 17:402–409PubMedCrossRefGoogle Scholar
  10. 10.
    Bassetti S, Hu J, D'Agostino RB Jr., Sherertz RJ (2001) Prolonged antimicrobial activity of a catheter containing chlorhexidine-silver sulfadiazine extends protection against catheter infections in vivo. Antimicrob Agents Chemother 45:1535–1538PubMedCrossRefGoogle Scholar
  11. 11.
    Collin GR (1999) Decreasing catheter colonization through the use of an antiseptic-impregnated catheter: a continuous quality improvement project. Chest 115:1632–1640PubMedCrossRefGoogle Scholar
  12. 12.
    Darouiche RO, Smith JA Jr, Hanna H, et al (1999) Efficacy of antimicrobial-impregnated bladder catheters in reducing catheter-associated bacteriuria: a prospective, randomized, multicenter clinical trial. Urology 54:976–981PubMedCrossRefGoogle Scholar
  13. 13.
    Pugach JL, DiTizio V, Mittelman MW, Bruce AW, DiCosmo F, Khoury AE (1999) Antibiotic hydrogel coated Foley catheters for prevention of urinary tract infection in a rabbit model. J Urol 162:883–887PubMedCrossRefGoogle Scholar
  14. 14.
    Raad I, Hanna H (1999) Intravascular catheters impregnated with antimicrobial agents: a milestone in the prevention of bloodstream infections. Support Care Cancer 7:386–390PubMedCrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 2003

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  • Lori L. Burrows

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