Access-Related Infections Involving the Buttonhole Technique

Blood Purif. 2016;41(4):306-12. doi: 10.1159/000443781. Epub 2016 Jan 28.

Abstract

Purpose: In this study, we discuss a mechanism of development of access-related Staphylococcus aureus infections in patients on buttonhole (BH) method and logically construct a measure to prevent such infections on the basis of the mechanism.

Summary: S. aureus can colonize a BH track. Once S. aureus colonizes a BH track, access-related infections may develop when the equilibrium is upset between the factors of host resistance and a level of bacterial growth in a BH track. Thus, the logically constructed measure to prevent access-related infections are as follows: (1) decolonization of S. aureus from a BH track by applying mupirocin ointment to a BH entry site when a patient has been proven to be a carrier of S. aureus in the track, (2) prevention of bacterial invasion of the BH track by a new method to remove a scab completely, and (3) control of bacterial growth in the BH track by disinfecting the site with diluted povidone-iodine solution (0.1% povidone-iodine solution) before access vessel cannulation.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents, Local / therapeutic use
  • Catheter-Related Infections / microbiology
  • Catheter-Related Infections / prevention & control*
  • Catheterization, Peripheral / adverse effects*
  • Catheterization, Peripheral / methods
  • Catheters, Indwelling
  • Female
  • Humans
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / physiopathology
  • Kidney Failure, Chronic / therapy*
  • Male
  • Mupirocin / therapeutic use
  • Povidone-Iodine / therapeutic use
  • Renal Dialysis*
  • Staphylococcal Infections / etiology
  • Staphylococcal Infections / microbiology
  • Staphylococcal Infections / prevention & control*
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / physiology

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents, Local
  • Povidone-Iodine
  • Mupirocin