The influence of seasonal factors on the incidence of peritoneal dialysis-associated peritonitis

Abstract

Objectives: To investigate the effects of climatic variables on peritoneal dialysis-associated peritonitis (PDAP) among patients receiving PD, such as seasonal variations in temperature and humidity. Methods: A retrospective analysis was performed on PD patients, from 1 January 2011, to 31 December 2019. We evaluated the influence of seasonal factors on peritonitis rates and outcomes. Results: Over the 9-year study period, 667 peritonitis episodes occurred, in 401 PD patients. Diarrhea-associated peritonitis occurred more frequently in summer compared with other seasons. Eating raw and cold food was identified as the primary cause of peritonitis in the summer. More peritonitis episodes occurred during summer. The peritonitis rate associated with gramnegative bacteria (p ¼ 0.050) during summer was higher than those in all other seasons. The gram-negative bacterial peritonitis rate was positively correlated with monthly mean temperature (r ¼ 0.504, p < 0.01) and humidity (r ¼ 0.561, p < 0.01). A similar trend was observed for Enterobacterial peritonitis (temperature: r ¼ 0.518, p < 0.01; humidity: r ¼ 0.456, p ¼ 0.001). Logistic regression analysis showed that summer was a risk factor for peritonitis (p ¼ 0.041). Peritonitis prognosis during summer was significantly worse than those for all other seasons (p ¼ 0.037). Conclusions: Seasonal variations exist in the incidence of dialysis-associated peritonitis, with peak incidents caused by gram-negative bacteria in the summer. High average temperature and humidity are associated with significant increases in the gram-negative bacteria and Enterobacterial peritonitis rates. Peritonitis prognosis during summer is worse.

Peritoneal dialysis in Dalmatian County, Croatia: 21 years of a single‐center experience

“…However, when we searched for variations in the seasonal distribution of APEs, we have found no statistically significant difference. This is in contrast with findings reported in a study by Zeng et al [18] who showed that high average temperature and humidity which are occurring during the summer are responsible for significant increases in APE rates with a worse prognosis than in other seasons. When analyzing the microbiological properties of each APE, we have shown that the most common microorganisms are coagulase‐negative Staphylococcus sp ., Streptococcus pyogenes, methicillin‐resistant Staphylococcus aureus , and methicillin‐sensitive Staphylococcus epidermidis (Figure 2).…”

Characteristics Analysis, Clinical Outcome and Risk Factors for Fungal Peritonitis in Peritoneal Dialysis Patients: A 10-Year Case-Control Study

“…This may be related to the small sample size in the FP group in our center and the conclusion is worthy of further discussion. Furthermore, seasonal changes may influence the occurrence of peritonitis by changing the patients' health and the microenvironment in recent study (32), while no significant effects were noted between the occurrence of FP and the seasons in our study. It deserves further investigation.…”

Clinical Application of Peritoneal Dialysis Catheterization without Capsular Puncture Technique

“…The incidence of noninfectious complications was closely related to the surgical procedures. The incidence of catheter drift in PD patients was reported to be 7.6%-16% [10,11], and the incidence of greater omentum wrapping was 3.2%-27% [12][13][14]. In order to reduce the high incidence of postoperative complications, the researchers at home and abroad have been searching for the optimal catheterization for many years.…”