Peritoneal dialysis-associated peritonitis: clinical features and predictors of outcome
Abstract number: P830
Kofteridis D.P., Valachis A., Perakis K., Papazoglou G., Stylianou K., Daphnis E., Samonis G.
Objectives: To identify epidemiological, clinical and microbiological factors affecting the outcome of patients with peritoneal dialysis (PD)-associated peritonitis
Materials and Methods: All of patients with PD-associated peritonitis, admitted to the University Hospital of Heraklion, Crete, Greece from 1990 to 2007 were identified and their charts were retrospectively studied.
Results: A total of 247 episodes of PD-associated peritonitis occurring in 82 patients have been evaluated. The median age of patients was 68 years (range 1092); 51 (62%) were males. Seventy-four (90%) had an underlying condition such as cardiovascular disease 48 (59%), diabetes mellitus 26 (32%), heart failure 17 (21%), autoimmune disease 6 (7%) and cancer 2 (2%). There were 104 episodes (42%) of Gram-positive, 46 (19%) of Gram-negative, 13 (5%) of polymicrobial and 11 (4%) of fungal peritonitis, while in 73 episodes (30%) cultures were negative. Regarding outcome, patients were divided into 2 groups: those with curable and those with complicated episodes. Complicated episodes were characterised by death due to peritonitis, relapse or repeated episode, removal of catheter and need for temporary or permanent haemodialysis. There were 183 (74%) curable, while 64 episodes (26%) were considered complicated and included 11 (4.5%) deaths, 22 (9%) relapses, 13 (5%) repeated episodes and 18 (7%) catheter removals. Multivariate analysis revealed that presence of purulent exit-site infection (P<0.001), peritoneal dialysis effluent cell count >100/ml for more than 5 days (P<0.001), prior antibiotic use during the last 3 months (P<0.05) and low serum total protein level on admission (P<0.05) were independent predictors of complicated episodes.
Conclusions: Exit-site infection, number of days with the peritoneal dialysis effluent cells count >100/ml, prior antibiotic use and serum total protein level are potential predictors of outcome in PD-associated peritonitis and may distinguish high-risk patients. Further study is needed to determine whether an aggressive management of these high-risk patients could improve outcome.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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