Evaluation of continuous ambulatory peritoneal dialysis-related peritonitis attacks in Ankara
Abstract number: 1734_129
Ozturk R., Bulut C., Yilmaz G.R., Parpucu H., Irmak H., Kinikli S., Duranay M., Demiroz A.P.
Objectives: Peritonitis is a serious and potentially life-threatening complication of continuous ambulatory peritoneal dialysis (CAPD). The aims of this study were to assess demographic aspects, rates of peritonitis, causative organisms, clinical outcomes and treatment approach for continuous ambulatory peritoneal dialysis (CAPD)-related peritonitis cases.
Methods: All peritonitis cases treated in Infectious Diseases and Clinical Microbiology Department between February 2006 and June 2006 were enrolled into this study. The patients with cloudiness of the peritoneal dialysis fluid and/or abdominal pain and with more than 100 white blood cells/mL in their dialysate fluid were accepted as having peritonitis. Gram stain, and cultures, complete blood count, serum procalcitonin (PCT) and C-reactive protein (CRP) levels were obtained. Conventional methods were used for identification of microorganism. Disc diffusion method was used for antimicrobial susceptibility tests.
Results: Fifty-six episodes of peritonitis occurred in 50 patients. The mean age of the patients was 48.4 years (range: 1883 years). The overall incidence of peritonitis was 1.6 episodes/patient-year. In 42% of patients, there was only one peritonitis attack; whereas 58% of them had two or more attacks. The most common presenting symptoms of the patients were abdominal pain, cloudiness of the peritoneal dialysate fluid, nausea and vomiting. The median white blood cell count of peritoneal dialysate fluid was 1275/mL (range: 1707900/mL) in 56 episodes. Cultures were positive in 40 (71.4%) peritonitis episodes; coagulase-negative Staphylococcus was the most common organism (20.7%), followed by Staphylococcus aureus (4%). In all of the episodes, the empirical therapy administered to the patients was intraperitoneal cefazolin and gentamicin. Antibiotherapies of 18 patients were changed according to antimicrobial susceptibility test results. Two culture negative patients did not respond to initial therapy and the therapy was switched to an empirical therapy with a glycopeptide antibiotic.
Conclusion: Despite all technical improvements during recent decades, peritonitis is still the major reason for CAPD failure. For the accurate treatment of peritonitis attacks, causative organisms and their antimicrobial susceptibilities must be known.
|Session name:||European Society of Clinical Microbiology and Infectious Diseases|
|Location:||ICC, Munich, Germany|
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