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Pigeons and peritonitis?

I Greaves1, K Kane, N T Richards

  • 1Department of Nephrology, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|January 1, 1992
PubMed

Insights

An outbreak of fungal peritonitis in chronic ambulatory peritoneal dialysis (CAPD) patients was linked to Candida parapsilosis. Environmental contamination, including pigeon guano, was identified as the source, leading to improved containment measures.

Area of Science:

  • Infectious Diseases
  • Nephrology
  • Mycology

Background:

  • Fungal peritonitis is a serious complication in patients undergoing chronic ambulatory peritoneal dialysis (CAPD).
  • Candida parapsilosis has emerged as a significant cause of fungal infections in healthcare settings.

Purpose of the Study:

  • To investigate an outbreak of fungal peritonitis in CAPD patients.
  • To identify the source and transmission route of Candida parapsilosis causing the peritonitis.

Main Methods:

  • Retrospective analysis of 12 CAPD patients with fungal peritonitis.
  • Microbiological investigation of the CAPD unit, medical ward, and environmental samples.
  • Treatment involved CAPD catheter removal and systemic antifungal therapy.

Main Results:

  • All 12 patients received treatment, with no peritonitis-related deaths.
  • Candida parapsilosis was isolated from the CAPD unit, ward, and pigeon guano.
  • Installation of bird-proof netting correlated with a decrease in peritonitis cases.

Conclusions:

  • Pigeons carrying Candida parapsilosis in their feces likely contaminated the CAPD environment, leading to the outbreak.
  • Environmental control measures, such as bird-proofing, are crucial in preventing fungal peritonitis in CAPD units.
  • Prompt diagnosis and treatment, including catheter removal and antifungal therapy, are essential for patient outcomes.

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