Predictive factors of outcome following staphylococcal peritonitis in continuous ambulatory peritoneal dialysis

Cunha, Maria de Lourdes Ribeiro de Souza da; Montelli, Augusto Cézar; Fioravante, Ana Maria; Batalha, Jackson E. N.; Caramori, Jacqueline Costa Teixeira; Barretti, Pasqual

doi:10.5414/cnp64378

Cited by 21 publications

(10 citation statements)

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“…In our conventional catheter group, only 5.1% of CoNS peritonitis episodes failed antibiotic therapy and required catheter removal. This agrees well with the 2.9% -9.8% range of catheter removal rates reported by others for CoNS peritonitis (13,14,17,18,21). In contrast, 56.2% of CoNS peritonitis episodes in the extended catheter group required catheter removal.…”

Section: Discussionsupporting

confidence: 91%

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Comparative Analysis of Two-Piece Extended Peritoneal Dialysis Catheters with Remote Exit-Site Locations and Conventional Abdominal Catheters

Crabtree

Burchette

2010

Perit Dial Int

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Section: Discussionsupporting

confidence: 91%

“…We found a significant association between BMI and the interaction of BMI and diabetic status with catheter loss from dialysis-related infections. Diabetic status alone, age, and gender were not significantly associated with catheter loss from in-fection, findings that have also been reported by others (13,14).…”

Section: Discussionsupporting

confidence: 84%

Comparative Analysis of Two-Piece Extended Peritoneal Dialysis Catheters with Remote Exit-Site Locations and Conventional Abdominal Catheters

Crabtree

Burchette

2010

Perit Dial Int

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“…Gram-positive cocci are the main etiological agents of peritonitis in the world, with coagulase-negative staphylococci (CoNS) being the most common microbial agents, whereas Staphylococcus aureus is associated with more severe episodes, a higher risk of hospitalization, catheter removal, and death [1], [2]. Although S. aureus is responsible for a small proportion of peritonitis episodes in most countries, it continues to be the leading cause of this infection in some Latin American countries, particularly in Brazil [3].…”

Section: Introductionmentioning

confidence: 99%

“…A poor prognosis of PD-related S. aureus peritonitis has been frequently reported [2], [4], [5], but there are only two reports [6], [7] that specifically describe the clinical outcome and predictors of treatment response in this infection. In the largest series, Govindarajulu et al [6] showed that methicillin-resistant S. aureus (MRSA) peritonitis was independently predictive of an increased risk of permanent hemodialysis transfer and tended to be associated with a high risk of hospitalization.…”

Section: Introductionmentioning

confidence: 99%

Peritoneal Dialysis-Related Peritonitis Due to Staphylococcus aureus: A Single-Center Experience over 15 Years

et al. 2012

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Peritonitis caused by Staphylococcus aureus is a serious complication of peritoneal dialysis (PD), which is associated with poor outcome and high PD failure rates. We reviewed the records of 62 S. aureus peritonitis episodes that occurred between 1996 and 2010 in the dialysis unit of a single university hospital and evaluated the host and bacterial factors influencing peritonitis outcome. Peritonitis incidence was calculated for three subsequent 5-year periods and compared using a Poisson regression model. The production of biofilm, enzymes, and toxins was evaluated. Oxacillin resistance was evaluated based on minimum inhibitory concentration and presence of the mecA gene. Logistic regression was used for the analysis of demographic, clinical, and microbiological factors influencing peritonitis outcome. Resolution and death rates were compared with 117 contemporary coagulase-negative staphylococcus (CoNS) episodes. The incidence of S. aureus peritonitis declined significantly over time from 0.13 in 1996–2000 to 0.04 episodes/patient/year in 2006–2010 (p = 0.03). The oxacillin resistance rate was 11.3%. Toxin and enzyme production was expressive, except for enterotoxin D. Biofilm production was positive in 88.7% of strains. The presence of the mecA gene was associated with a higher frequency of fever and abdominal pain. The logistic regression model showed that diabetes mellitus (p = 0.009) and β-hemolysin production (p = 0.006) were independent predictors of non-resolution of infection. The probability of resolution was higher among patients aged 41 to 60 years than among those >60 years (p = 0.02). A trend to higher death rate was observed for S. aureus episodes (9.7%) compared to CoNS episodes (2.5%), (p = 0.08), whereas resolution rates were similar. Despite the decline in incidence, S. aureus peritonitis remains a serious complication of PD that is associated with a high death rate. The outcome of this infection is negatively influenced by host factors such as age and diabetes mellitus. In addition, β-hemolysin production is predictive of non-resolution of infection, suggesting a pathogenic role of this factor in PD-related S. aureus peritonitis.

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“…This method has been employed by several investigators with reliable results and has been shown to be efficient, presenting excellent sensitivity and adequate specificity, providing a consistent and adequate diagnosis in routine applications (24,27,28,38,44,50). In a study comparing the reliability of three biofilm detection methods in S. aureus, a TCP assay, a tube test and Congo red agar, Knobloch et al (49) reported good correlation between the tube test (13) and TCP assay for strongly biofilm-producing strains, whereas weak producers were not safely discriminated from non-producing strains.…”

Section: Slime Production By Coagulase-negative Staphylococci and Itsmentioning

confidence: 99%

Bacterial biofilms with emphasis on coagulase-negative staphylococci

Oliveira¹,

Cunha²

2008

J. Venom. Anim. Toxins incl. Trop. Dis

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In addition to their capacity to attach to surfaces, various groups of microorganisms also produce an extracellular polymeric substance known as "slime". This slime forms a thin layer around cells known as biofilm. Thus, biofilm structure comprises bacterial cells and an extracellular polymeric substance. It also presents a defined architecture, providing the microorganisms with an excellent protective environment and favoring the exchange of genetic material between cells as well as intercellular communication. The ability to produce biofilm is observed in a large group of bacteria, including coagulase-negative staphylococci (CNS) which are the predominant microorganisms of normal skin flora and have been implicated as the causative agents of hospital infections. Bacteremia caused by these agents is common in immunodepressed persons, in patients with cancer, in adult and neonatal intensive care units (ICU) and in patients using catheters or other prosthetic devices. The pathogenicity of CNS infections is probably related to the production of slime, which adheres preferentially to plastic and smooth surfaces, forming a biofilm that protects against attacks from the immune system and against antibiotic treatment, a fact hindering the eradication of these infections. The main objective of the present review was to describe basic and genetic aspects of biofilm formation and methods for its detection, with emphasis on biofilm creation by CNS and its relationship with diseases caused by these microorganisms which are becoming increasingly more frequent in the hospital environment.

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Predictive factors of outcome following staphylococcal peritonitis in continuous ambulatory peritoneal dialysis

Cited by 21 publications

References 0 publications

Comparative Analysis of Two-Piece Extended Peritoneal Dialysis Catheters with Remote Exit-Site Locations and Conventional Abdominal Catheters

Comparative Analysis of Two-Piece Extended Peritoneal Dialysis Catheters with Remote Exit-Site Locations and Conventional Abdominal Catheters

Peritoneal Dialysis-Related Peritonitis Due to Staphylococcus aureus: A Single-Center Experience over 15 Years

Bacterial biofilms with emphasis on coagulase-negative staphylococci

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