Which of the following BEST reduces the risk of infection in patients undergoing peritoneal dialysis?

The CBIC Certified Infection Control Exam Study Guide (6th edition) emphasizes that the most effective strategy for reducing infection risk in peritoneal dialysis (PD) patients is ensuring optimal conditions at the time of catheter insertion. Placement of the peritoneal dialysis catheter in the operating room provides a controlled, sterile environment that minimizes microbial contamination and significantly reduces the risk of early peritonitis and exit-site infections.

Peritoneal dialysis–associated infections are most often linked to contamination during catheter insertion or manipulation. Performing catheter insertion in the operating room allows for strict adherence to aseptic technique, appropriate airflow controls, surgical hand antisepsis, and use of sterile instruments—all of which are essential infection prevention measures highlighted in the Study Guide.

The other options are less effective or not recommended. Daily dressing changes (Option A) may actually increase manipulation of the exit site and raise infection risk if not clinically indicated. Weekly surveillance cultures (Option B) are not recommended, as they do not prevent infection and may lead to unnecessary antimicrobial use. Irrigating catheters with antimicrobials (Option D) is discouraged because it has not been shown to reduce infection rates and may contribute to antimicrobial resistance.

For the CIC® exam, it is important to recognize that prevention of peritoneal dialysis–associated infection begins with proper catheter placement under optimal sterile conditions, making operating room insertion the best answer.

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