Recurrent and Relapsing Peritonitis: Causative Organisms and Response to Treatment

Szeto, Cheuk‐Chun; Kwan, Bonnie Ching‐Ha; Chow, Kai‐Ming; Law, Man-Ching; Pang, Wing‐Fai; Chung, Kwok-Yi; Leung, Chi‐Bon; Li, Philip Kam-Tao

doi:10.1053/j.ajkd.2009.04.032

Cited by 64 publications

(60 citation statements)

References 24 publications

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“…Stronger consideration should be given to timely catheter removal (Opinion) (133). This single copy is for your personal, non-commercial use only.…”

Section: Relapsing Recurrent and Repeat Peritonitismentioning

confidence: 99%

Peritoneal Dialysis-Related Infections Recommendations: 2010 Update

et al. 2010

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“…Stronger consideration should be given to timely catheter removal (Opinion) (133). This single copy is for your personal, non-commercial use only.…”

Section: Relapsing Recurrent and Repeat Peritonitismentioning

confidence: 99%

Peritoneal Dialysis-Related Infections Recommendations: 2010 Update

et al. 2010

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“…Although relapsing peritonitis is not counted as a new episode in calculating a center's peritonitis rate, the center must still carefully track relapsing episodes and repeat episodes (which should be counted as new episodes in calculating the total rate). Relapsing and recurrent peritonitis have been found to be caused by different spectra of bacteria and may therefore represent distinct clinical entities (98). Recurrent peritonitis appears to have the poorer prognosis (98).…”

Section: Reducing the Risk Of Relapse And Repeat Peritonitismentioning

confidence: 99%

“…One peritonitis episode appears to increase the risk of another episode (98,133). It is unclear whether that risk is a result of a depressed intraperitoneal immune response or of inadequate exchange technique, or both.…”

Section: Reducing the Risk Of Relapse And Repeat Peritonitismentioning

confidence: 99%

ISPD Position Statement on Reducing the Risks of Peritoneal Dialysis–Related Infections

et al. 2011

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“…PATIENT MANAGEMENT Peritonitis episodes were treated with the standard antibiotic protocol of our center, which has changed systemically over time (15). Initial antibiotics for peritonitis were generally intraperitoneal administration of a third-or fourth-generation cephalosporin, plus or minus vancomycin, or cefazolin plus gentamicin.…”

Section: Clinical Featuresmentioning

confidence: 99%

Persistent Symptomatic Intra-Abdominal Collection after Catheter Removal for Pd-Related Peritonitis

et al. 2011

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♦ ♦ ♦ ♦ ♦ Background: Peritoneal dialysis (PD) patients with severe peritonitis require catheter removal. It is often assumed that this approach, together with antibiotics, would eradicate the infection; however, some patients continue to have problems despite catheter removal. ♦ ♦ ♦ ♦ ♦ Method: We reviewed 30 consecutive PD patients in our center from 1997 to 2008 with recurrent loculated peritoneal collection after catheter removal for severe peritonitis. ♦ ♦ ♦ ♦ ♦ Results: Of the 1928 episodes of peritonitis that occurred in 702 patients during the study period, 11.1% required catheter removal and 1.6% developed recurrent peritoneal collection that required percutaneous drainage. Median time to diagnosis of intra-abdominal collection was 12 days after catheter removal (interquartile range 7 -61 days). In 25 patients (83.3%), aspirate of the abdominal collection was culture negative. In 17 patients (56.7%), the abdominal collection was recurrent and required repeated percutaneous aspiration. Only 3 patients had successful reinsertion of the peritoneal catheter but all had reduced small solute clearance after returning to PD. ♦ ♦ ♦ ♦ ♦ Conclusion: A small but not negligible proportion of patients with PD-related peritonitis develop recurrent intraabdominal collection that requires percutaneous drainage after catheter removal. The chance of a successful return to PD is very low in this group of patients. Direct conversion to long-term hemodialysis may avoid unnecessary attempts at peritoneal catheter reinsertion.

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Recurrent and Relapsing Peritonitis: Causative Organisms and Response to Treatment

Cited by 64 publications

References 24 publications

Peritoneal Dialysis-Related Infections Recommendations: 2010 Update

Peritoneal Dialysis-Related Infections Recommendations: 2010 Update

ISPD Position Statement on Reducing the Risks of Peritoneal Dialysis–Related Infections

Persistent Symptomatic Intra-Abdominal Collection after Catheter Removal for Pd-Related Peritonitis

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