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Peritonitis with Pseudomonas aeruginosa in hospital patients treated with peritoneal dialysis
Abstract:
From December 1976 to July 1977 Pseudomonas aeruginosa was cultured from the dialysate of 8 hospital patients on peritoneal dialysis. Seven of the cases occurred within 1 month. The source of the epidemic was a water bath used to preheat the dialysis fluids before start of dialysis. Six patients developed a severe protracted peritonitis with Ps. aeruginosa. Continuous peritoneal dialysis with antibiotics added to the dialysis fluid did not eradicate infection, but after removal of the catheters signs of peritonitis subsided rapidly in all patients. In conclusion, water baths used for this purpose should be replaced by dry-heat incubators.
Insights
A Pseudomonas aeruginosa outbreak in 8 peritoneal dialysis patients was traced to a contaminated water bath. Dry-heat incubators are recommended to prevent future dialysis fluid infections.
Area of Science:
- Infectious Diseases
- Nephrology
- Hospital Epidemiology
Background:
- Pseudomonas aeruginosa (Ps. aeruginosa) is an opportunistic pathogen.
- Peritoneal dialysis is a common treatment for kidney failure.
- Nosocomial infections can complicate patient care.
Purpose of the Study:
- To identify the source of a Ps. aeruginosa outbreak among peritoneal dialysis patients.
- To evaluate treatment strategies for Ps. aeruginosa peritonitis.
- To recommend preventative measures for dialysis-associated infections.
Main Methods:
- Retrospective case series analysis.
- Microbiological culturing of dialysate.
- Epidemiological investigation to identify the common source.
Main Results:
- Eight peritoneal dialysis patients were infected with Ps. aeruginosa between December 1976 and July 1977.
- A shared water bath used for preheating dialysis fluids was identified as the epidemic source.
- Six patients experienced severe peritonitis; antibiotics in dialysis fluid were ineffective, but catheter removal led to rapid recovery.
Conclusions:
- Contaminated water baths pose a significant risk for dialysis-associated infections.
- Dry-heat incubators are a safer alternative for warming dialysis fluids.
- Prompt removal of infected catheters is crucial for patient recovery.