Fungal peritonitis in peritoneal dialysis: 5-year review from a North China center

Hu, Shouci; Ren, Tong; Yang, Bo; Pei, Ming; Yang, Hongtao

doi:10.1007/s15010-018-1204-7

Cited by 34 publications

(45 citation statements)

References 33 publications

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“…We then estimated Candida peritonitis by assuming that there were 2 episodes of candidemia per episode of intraabdominal candidiasis in the ICU, based on a large prospective study (20). In addition, we estimated Candida peritonitis in CAPD using data from the First Affiliated Teaching Hospital in Tianjin (21). For RVVC, when prevalence data were not available, we used the rate of women with RVVC from a recent global estimate (22).…”

Section: Analysis Of Data Candidiasis Burden Estimationsmentioning

confidence: 99%

Risk-Based Estimate of Human Fungal Disease Burden, China

Zhou¹,

Jiang²,

Li³

et al. 2020

Emerg. Infect. Dis.

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F ungal diseases constitute a growing problem worldwide, causing a large, but poorly quantified, impact on public health (1). The incidence of fungal infections varies according to geographic region, socioeconomic conditions, and the number of persons with underlying conditions. China is one of the largest countries in the world (largest population and third largest land area). It has almost every type of weather niche, from the Pacific coast in the south to the snowy mountains in the Qinghai-Tibet Plateau, and even tropical rain forest. Many endemic fungal infections are present in China, along with globally distributed fungal pathogens. Although China has become the world's second largest economy, it is still a developing country, with millions of impoverished citizens who are susceptible to fungal infections. Fungal keratitis, one of the major causes of avoidable blindness, has been relatively neglected (2). Moreover, old pathogens such as Histoplasma and Talaromyces marneffei (talaromycosis) have expanded (3,4); new hosts contributing to new therapies for malignant and autoimmune disease have increased (5,6); and new patterns, including aspergillosis in pulmonary tuberculosis (PTB) and chronic obstructive pulmonary disease (COPD), are emerging (7,8). In addition, the lack of effective drugs, shortages of well-trained medical care personnel, and unaffordable antifungal drugs result in severe outcomes. Therefore, an estimation of fungal disease burden is needed for China to increase public health awareness and facilitate effective interventions. As in most other countries, fungal infections are not reportable in China, and the incidence and prevalence are difficult to calculate because of the lack of population-based surveillance data and few high quality epidemiology studies. The Chinese National Fungal Diseases Surveillance System (http://www. chifungi.cn) was established on May 18, 2019, but no data have been released yet. Even with this dearth of data, we have attempted to estimate the burden of fungal disease in China. Materials and Methods Study Procedures We conducted a literature review for published epidemiology papers that discussed fungal infections in China. If no epidemiological data existed for a particular fungal disease, we estimated the burden based on fungal infection incidence or prevalence and the specific populations at risk (Figure 1; Appendix Table 1, https://wwwnc.cdc.gov/EID/article/26/9/20-0016-App1.pdf).

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Section: Analysis Of Data Candidiasis Burden Estimationsmentioning

confidence: 99%

Risk-Based Estimate of Human Fungal Disease Burden, China

Zhou¹,

Jiang²,

Li³

et al. 2020

Emerg. Infect. Dis.

View full text Add to dashboard Cite

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“…The incidence worldwide is heterogenous with rates varying from 2 to 23.8% [2]. In the United Kingdom an audit study reported a fungal peritonitis rate of 0.0099/patient year from centres not using prophylaxis and a lower rate of 0.0032/patient year in centres using daily oral fluconazole [3]. Despite its rarity fungal peritonitis is important due to its associated higher rates of catheter loss, morbidity and mortality [3].…”

Section: Introductionmentioning

confidence: 99%

“…In the United Kingdom an audit study reported a fungal peritonitis rate of 0.0099/patient year from centres not using prophylaxis and a lower rate of 0.0032/patient year in centres using daily oral fluconazole [3]. Despite its rarity fungal peritonitis is important due to its associated higher rates of catheter loss, morbidity and mortality [3]. Candida species are the commonest pathogen isolated in fungal peritonitis, accounting for 70-90% of the cases described [3].…”

Section: Introductionmentioning

confidence: 99%

“…Despite its rarity fungal peritonitis is important due to its associated higher rates of catheter loss, morbidity and mortality [3]. Candida species are the commonest pathogen isolated in fungal peritonitis, accounting for 70-90% of the cases described [3]. Patients at particular risk for fungal peritonitis are those who have had previous bacterial peritonitis, been on prolonged antibiotic treatment, have gynaecological or bowel sources of infection, those who are immunosuppressed, have diabetes mellitus, are malnourished, or have a prolonged time on PD [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…Candida species are the commonest pathogen isolated in fungal peritonitis, accounting for 70-90% of the cases described [3]. Patients at particular risk for fungal peritonitis are those who have had previous bacterial peritonitis, been on prolonged antibiotic treatment, have gynaecological or bowel sources of infection, those who are immunosuppressed, have diabetes mellitus, are malnourished, or have a prolonged time on PD [2,3]. We describe a case where Rhodotorula muciliginosa was isolated from a patients' peritoneal dialysate fluid following an accidental set disconnection.…”

Section: Introductionmentioning

confidence: 99%

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Along came a spider: an unusual organism identified in a peritoneal dialysis patient, a case report and literature review

et al. 2020

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Background Peritoneal dialysis-associated peritonitis can uncommonly be caused by fungal infections. When they do present, they are associated with significant mortality and morbidity. We describe a case where a sample of peritoneal dialysate fluid grew Rhodotorula muciliginosa, a yeast organism present in the normal environment which has previously been reported as rarely causing peritonitis. We believe this is the first case where the Rhodotorula spp. and its origin has been identified. Case presentation A 20 year old male grew Rhodotorula muciliginosa from his peritoneal dialysis fluid on three separate occasions when a fluid sample was sent following a disconnection and subsequent set change. He was not systemically unwell and his peritoneal dialysate was clear. As Rhodotorula spp. is exceedingly difficult to treat our patient had his Tenchkoff catheter removed. Subsequent samples of soil and sand from his bearded dragon and Chilean tarantula cases, kept in his bedroom where dialysis occurred, were tested. The tarantula sand was identified as the source of the Rhodotorula spp. Of note, Candida was isolated from sand from the bearded dragon case. Once his Tenchkoff was removed he was treated with an intravenous course of antifungal therapy. He has since had a new Tenchkoff catheter inserted and recommenced PD following education around pets and hygiene. Conclusions In this era where people are keeping increasingly rare and unusual wildlife in their homes, this case highlights the need for clinician and nursing staff awareness of a patient’s home environment and hobbies when they are undergoing peritoneal dialysis. Sand from our patient’s tarantula case grew the colonising organism but interestingly soil from his bearded dragon case also isolated candida. This can also cause difficult to treat peritonitis.

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