Pathogens of peritoneal dialysis peritonitis: Trends from a single-center experience over 15 years

Hwang, Tae Yeon; Kim, Myung Gyu; Oh, Se Won; Jo, Sang-Kyung; Cho, Won Yong; Yang, Jihyun

doi:10.23876/j.krcp.19.035

Cited by 6 publications

(5 citation statements)

References 23 publications

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“…This is basically consistent with the results of Hwang et al. [ 8 ]. The number of gram-negative bacterial peritonitis episodes in the 2014–2018 group was significantly higher than that in the 2009–2013 group, which is consistent with the conclusion that gram-negative bacterial peritonitis has demonstrated an increasing trend, which has been reported by several countries and regions [ 9 ].…”

Section: Discussionsupporting

confidence: 94%

Peritoneal dialysis-related peritonitis caused by gram-negative organisms: ten-years experience in a single center

et al. 2021

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Objectives: Concerns are increasing about the clinical characteristics of gram-negative bacterial peritonitis for providing reference for clinical diagnosis, treatment and prevention. Methods: A retrospective analysis was performed examining patients who developed peritoneal dialysis-related peritonitis (PDRP) from 1 January 2009 to 31 December 2018. Results: Among 898 PD patients, 677 episodes of peritonitis occurred in 344 patients. Over 10 years, the proportion of gram-negative bacterial peritonitis increased from 0% to 26.15% (p ¼ .045). E. coli was the leading cause (38.51%) of the 148 cases of gram-negative bacterial peritonitis. The increase of E. coli peritonitis between the first 5 and the last 5 years was obvious (20.45% vs. 46.15%). The antimicrobial sensitivity of gram-negative organisms to cefotaxime decreased from 71.43% to 55.84% (p ¼ .017). In the gram-negative group, the effluent white cell count (WCC) on the first day was larger (OR: 1.374;95%CI: 1.248-1.563; p < .001), the time required for the WCC to normalize was longer (OR: 1.100;95%CI: 1.037-1.189; p ¼ .003), and the level of C-reactive protein (CRP) was higher (OR: 1.038;95%CI: 1.026-1.042; p < .001) than those in the gram-positive group. The complete cure rate and treatment failure rate of gram-negative bacteria peritonitis were 87.8% and 12.2% respectively. Conclusions: Over 10 years, the proportion of gram-negative bacterial peritonitis increased, with E. coli epidermidis being the most common pathogen. More effluent WCC on the first day, longer time required for the WCC to normalize, and higher level of CRP are more common for gram-negative bacterial peritonitis. Prognosis of gram-negative bacterial peritonitis is worse.

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Section: Discussionsupporting

confidence: 94%

Peritoneal dialysis-related peritonitis caused by gram-negative organisms: ten-years experience in a single center

et al. 2021

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“…This rate was reported as 59.2% by Ponce et al In addition, the detection rate of gram‐positive and gram‐negative organisms was found similar to that study [15]. Although there is a study showing that the culture negativity rate has improved significantly in recent years [22], although our study covers the years between 2015 and 2020, the rate of culture negativity is still very high. Although Dotis et al found the rate of gram positivity as 65.2% in pediatric patients who underwent APD, the number of patients included in the study and the number of peritonitis episode were very low [13].…”

Section: Discussionsupporting

confidence: 86%

Sociodemographic features and outcomes of peritonitis episodes in children on peritoneal dialysis

Pınarbaşı

Kara

2022

Ther Apher Dial

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Introduction Peritoneal dialysis (PD) is one of the most preferred kidney replacement therapies in children. However, it has an important complication such as peritonitis. This study was planned to investigate the causes and frequency of peritonitis in children with PD. Methods The demographic features, peritonitis episodes, and microbiological characteristics of PD patients followed up for 5 years. Results Overall, 50 pediatric PD patients who met the study criteria in a 5‐year period were included in the study. Consanguineous marriage was 64% and 44% of the mothers was illiterate. A total of 19 patients had no peritonitis episode, and a total of 54 peritonitis episode were experienced. The overall peritonitis rate was one episode per 24.4 patient‐months. Culture negativity rate was 44%. Conclusion Even though factors such as the education level of the parents, the number of people or rooms in the house, dialysis modality were thought to influence peritonitis episodes, they could not be shown statistically.

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“…The sources of these variations may be center-related factors, such as center size, topical antibiotic prophylaxis, and PD training [2]. To date, few articles describe the chronological changes in peritonitis rates, and most reports are from a single center [12,[14][15][16][17]. In our multicenter study, we demonstrated a significant decrease in the peritonitis rate during the study period, especially over the last 3 years, which could be attributable to the significant decrease in G+ PDAP, G-PDAP, and culture-negative PDAP rates.…”

Section: Discussionmentioning

confidence: 99%

Clinical features and risk factors of catheter removal among 1062 episodes of peritoneal dialysis‐associated peritonitis: A multicenter 7‐year study

et al. 2022

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Introduction: Studies focusing on catheter removal and the pathogenic spectrum of peritoneal dialysis-associated peritonitis (PDAP) need to be updated. Methods: Data were collected from four peritoneal dialysis (PD) centers. Peritonitis rates were compared using Poisson regression and Logistic regression was used to examine the risk factors for catheter removal. Results: The PD duration (odds ratio [OR], 1.021; 95% confidence interval [CI], 1.010-1.032), number of previous PDAP episodes (OR, 1.267; 95% CI, 1.039-1.545), dialysate white cell count >100 Â 10 6 /L on Day 5 of PDAP (OR, 6.088; 95% CI, 3.277-11.312), Pseudomonas aeruginosa (OR, 4.122; 95% CI, 1.071-15.874) and polymicrobial infections (OR, 3.257; 95% CI, 1.519-6.982) were independent predictors of catheter removal (p < 0.05). The prevalence of polymicrobial peritonitis and fungal peritonitis has increased (p < 0.05). Conclusion: Attention should be paid to patients with long PD duration or a history of previous episodes of PDAP characteristics.

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Pathogens of peritoneal dialysis peritonitis: Trends from a single-center experience over 15 years

Cited by 6 publications

References 23 publications

Peritoneal dialysis-related peritonitis caused by gram-negative organisms: ten-years experience in a single center

Peritoneal dialysis-related peritonitis caused by gram-negative organisms: ten-years experience in a single center

Sociodemographic features and outcomes of peritonitis episodes in children on peritoneal dialysis

Clinical features and risk factors of catheter removal among 1062 episodes of peritoneal dialysis‐associated peritonitis: A multicenter 7‐year study

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