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April 17, 1967

Prevention of Infection In Peritoneal Dialysis

JAMA. 1967;200(3):263. doi:10.1001/jama.1967.03120160129036

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To the Editor:—  In the communication "Prevention of Infection During Dialysis," Schwartz et al (199: 79, 1967) point to the intestinal tract as the source of bacteria which contaminate the peritoneum during dialysis for the treatment of renal insufficiency, and to the effectiveness of orally administered neomycin and brief intermittent periods of dialysis to avoid or reduce the incidence of peritonitis.The authors refer to our initial study of peritoneal dialysis (120: 703, 1964) in which we were concerned with bacterial contamination of the peritoneum from the irrigation fluid and the openings in the abdominal wall. But our subsequent experimental and clinical studies (Ann Surg124:857, 1946; AnnSurg128:561, 1948; New Eng J Med242:747, 1950; and J Clin Invest25:747, 1950) demonstrated that bacterial contamination that occurs in the absence of invasion via the catheter, irrigation fluid, or the abdominal incision is caused by