Incidence and clinical features of patients with peritoneal dialysis peritonitis complicated by bacteremia

Abstract

The standard treatment of peritoneal dialysis peritonitis (PD peritonitis) is intraperitoneal antibiotic therapy. In patients with PD peritonitis complicated by bacteremia, intraperitoneal antibiotics combined with elective removal of the infected intraperitoneal catheter may be inadequate.We collected data of all patients with PD peritonitis admitted to Chi-Mei Medical Center during a 4-year period. We reviewed the medical records of the study cohort and collected their in-hospital details. Patients with positive blood culture results were assigned to the bacteremia group, whereas those with negative blood culture results were assigned to the peritonitis-only group.We discovered that 11.0% of patients with PD peritonitis had bacteremia complications, and immunocompromised comorbidities were more common in the bacteremia group than in the peritonitis-only group (66.7% vs 37.2%, P = .022). Additionally, the bacteremia group exhibited higher temperatures, greater respiratory rates, and lower serum sodium levels than the peritonitis-only group (temperature, 37.7 vs 37.2 °C, P = .014; respiratory rate, 19.1 vs 17.9 rate/min, P = .008; serum sodium level, 130.3 vs 132.7 mEq/L, P = .031). No mortality was found in patients with PD peritonitis complicated by bacteremia after intravenous and intraperitoneal antibiotic therapy.More than 1 in 10 patients with PD peritonitis was complicated by bacteremia, which resulted in extensive systemic derangements. Patients with immunocompromised comorbidities carried a higher risk of developing bacteremia, resulting in prolonged hospital stays. Combination of intraperitoneal and intravenous antibiotics therapies achieved fair prognoses in patients with PD peritonitis complicated by bacteremia.

The Presence of Bacteremia Indicates Higher Inflammatory Response and Augments Disease Severity in Adult Patients with Urinary Tract Infections

“…In patients with nosocomial pneumonia and soft tissue infection, bacteremia increased the mortality rate [ 21 , 22 ]. In patients with peritoneal dialysis peritonitis, bacteremia prolonged hospital stays and did not decrease the survival rate [ 23 ]. This study’s results from the two-group comparison and multivariate logistic regression indicated that bacteremia increased the requirement for intensive care in patients with UTI.…”

Pacientes em diálise peritoneal: associação entre diagnósticos de enfermagem e seus componentes

“…International research has identified sepsis as the second leading cause of death in patients on peritoneal dialysis, thereby demonstrating an increased risk in patients with more than one episode during treatment. (9) In a study developed in Brazil with a sample of 90 patients, almost half (42.2%) had peritonitis, of which 15.5% had two or more episodes. (10) This is the main complication of peritoneal dialysis, whether in manual (MPD) or automated (APD).…”

Effect of low-calcium and standard-calcium dialysate on serum calcium, phosphorus and full-segment parathyroid hormone in patients on peritoneal dialysis: A retrospective observational study

“…8,9 Peritoneal dialysis (PD) is a standard, economic, convenient and effective renal replacement therapy for patients with CKD. 10 Adjusting the calcium ion concentration in PD fluid is essential to correct the calcium and phosphorus balance in PD patients. 11 Studies have pointed out that using low-calcium dialysate combined with phosphatelowering drugs and active vitamin D can better control blood calcium, phosphorus and PTH in patients and prevent and treat hyperphosphataemia, negative calcium balance, SHPT, renal failure and bone disease.…”