Microbiological aspects of peritonitis associated with continuous ambulatory peritoneal dialysis.

Graevenitz, Alexander von; Amsterdam, D

doi:10.1128/cmr.5.1.36-48.1992

Cited by 19 publications

(38 citation statements)

References 86 publications

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“…Gram-positive bacteria ( predominantly Staphylococcus spp and to a lesser extent, Streptococcus and Corynebacterium spp) account for >60% of cultured microorganisms. Gram-negative bacteria (mostly E. coli, Klebsiella, and Enterobacter spp) represent <30% of positive cultures while anaerobes comprise <3% of isolates [118,121,122]. Fungi, especially Candida species contribute to the same number of identified infections as anaerobes [121].…”

Section: Peritoneal Dialysis-associated Peritonitis (Pdap)mentioning

confidence: 99%

“…Blood cultures are rarely positive in cases of PDAP [118]. Direct inoculation of dialysate or a concentrated dialysate into an aerobic blood culture bottle for automated detection has proven to be as effective as direct plating of centrifuged fluid [122,123]. Consult directly with the microbiology laboratory when primary cultures of fluid are negative and additional cultures for slowly growing or highly fastidious organisms such as Mycobacterium, Nocardia and filamentous fungi should be pursued.…”

Section: Peritoneal Dialysis-associated Peritonitis (Pdap)mentioning

confidence: 99%

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A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2013 Recommendations by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM)a

Baron

Miller

Weinstein

et al. 2013

Clinical Infectious Diseases

467

339

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The critical role of the microbiology laboratory in infectious disease diagnosis calls for a close, positive working relationship between the physician and the microbiologists who provide enormous value to the health care team. This document, developed by both laboratory and clinical experts, provides information on which tests are valuable and in which contexts, and on tests that add little or no value for diagnostic decisions. Sections are divided into anatomic systems, including Bloodstream Infections and Infections of the Cardiovascular System, Central Nervous System Infections, Ocular Infections, Soft Tissue Infections of the Head and Neck, Upper Respiratory Infections, Lower Respiratory Tract infections, Infections of the Gastrointestinal Tract, Intraabdominal Infections, Bone and Joint Infections, Urinary Tract Infections, Genital Infections, and Skin and Soft Tissue Infections; or into etiologic agent groups, including Tickborne Infections, Viral Syndromes, and Blood and Tissue Parasite Infections. Each section contains introductory concepts, a summary of key points, and detailed tables that list suspected agents; the most reliable tests to order; the samples (and volumes) to collect in order of preference; specimen transport devices, procedures, times, and temperatures; and detailed notes on specific issues regarding the test methods, such as when tests are likely to require a specialized laboratory or have prolonged turnaround times. There is redundancy among the tables and sections, as many agents and assay choices overlap. The document is intended to serve as a reference to guide physicians in choosing tests that will aid them to diagnose infectious diseases in their patients.

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Section: Peritoneal Dialysis-associated Peritonitis (Pdap)mentioning

confidence: 99%

Section: Peritoneal Dialysis-associated Peritonitis (Pdap)mentioning

confidence: 99%

A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2013 Recommendations by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM)a

Baron

Miller

Weinstein

et al. 2013

Clinical Infectious Diseases

467

339

View full text Add to dashboard Cite

show abstract

“…2,3 The percentage of neutrophils in a differential white cell count was >50%, and this seems to be an even more sensitive indicator of peritonitis than the absolute cell count. 4,5 Non-peritonitic fluids mostly demonstrate mononuclear cells, while infected fluids (including those caused by fungi and mycobacteria) generally show a predominance of polymorphonuclear leucocytes. 4 The differential white cell count, however, is highly unreliable for predicting the type of organism responsible.…”

Section: Associate Professor David Johnsonmentioning

confidence: 99%

“…Infected peritoneal fluid may be associated with sterile cultures in up to 20% of cases of CAPD peritonitis. 5 The possible reasons for this are listed in Table 2. Between 30 and 50% of culture-negative peritonitis episodes are related to previous antibiotic use prior to dialysate cultures being taken; although this factor does not appear to be responsible in this case.…”

Section: Associate Professor David Johnsonmentioning

confidence: 99%

“…Culture sensitivity may also be reduced by low concentrations of microorganisms in peritoneal dialysis (PD) fluids because of short dwell times, phagocytosis and bacterial die-off in dialysate effluent. 5,16 These problems are, at least, partly obviated by culturing at least 10 mL of dialysate effluent 17 following dwells of at least 4 h, and sending the cultures to the laboratory for processing within 12 h. 16 Culture yields in the microbiology laboratory may also be augmented by using enrichment broth with antiphagocytic and lytic properties, 5 and semiautomated blood culture systems. 18 Subcultures of the enrichment should at least be performed on aerobic chocolate agar and anaerobic blood agar for a period of at least 7 days.…”

Section: Associate Professor David Johnsonmentioning

confidence: 99%

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A peritoneal dialysis patient with fatal culture‐negative peritonitis

2003

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SUMMARY: Culture-negative peritoneal inflammation accounts for between 5 and 20% of cases of peritonitis in peritoneal dialysis patients. Diagnostic yields may be enhanced considerably by reculturing dialysate effluents using appropriate collection methods and optimal laboratory techniques (including prolonged low-temperature and anaerobic incubations). In patients with persistent culture-negative peritonitis, consideration should be given to the possibilities of unusual or fastidious microorganisms (especially fungi and mycobacteria) and non-infective causes (especially drug reactions, malignancy, visceral inflammation and retroperitoneal inflammation). In this paper, an illustrative case of persistent culture-negative peritonitis is presented followed by a discussion of the investigative approach to such patients, with particular emphasis on differential diagnosis and the limitations of currently available tests.

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A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiologya

Miller

Binnicker

Campbell

et al. 2018

Clinical Infectious Diseases

404

257

View full text Add to dashboard Cite

The critical nature of the microbiology laboratory in infectious disease diagnosis calls for a close, positive working relationship between the physician/advanced practice provider and the microbiologists who provide enormous value to the healthcare team. This document, developed by experts in laboratory and adult and pediatric clinical medicine, provides information on which tests are valuable and in which contexts, and on tests that add little or no value for diagnostic decisions. This document presents a system-based approach rather than specimen-based approach, and includes bloodstream and cardiovascular system infections, central nervous system infections, ocular infections, soft tissue infections of the head and neck, upper and lower respiratory infections, infections of the gastrointestinal tract, intra-abdominal infections, bone and joint infections, urinary tract infections, genital infections, and other skin and soft tissue infections; or into etiologic agent groups, including arthropod-borne infections, viral syndromes, and blood and tissue parasite infections. Each section contains introductory concepts, a summary of key points, and detailed tables that list suspected agents; the most reliable tests to order; the samples (and volumes) to collect in order of preference; specimen transport devices, procedures, times, and temperatures; and detailed notes on specific issues regarding the test methods, such as when tests are likely to require a specialized laboratory or have prolonged turnaround times. In addition, the pediatric needs of specimen management are also emphasized. There is intentional redundancy among the tables and sections, as many agents and assay choices overlap. The document is intended to serve as a guidance for physicians in choosing tests that will aid them to quickly and accurately diagnose infectious diseases in their patients.

show abstract

Microbiological aspects of peritonitis associated with continuous ambulatory peritoneal dialysis.

Cited by 19 publications

References 86 publications

A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2013 Recommendations by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM)a

A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2013 Recommendations by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM)a

A peritoneal dialysis patient with fatal culture‐negative peritonitis

A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiologya

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