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Fungal peritonitis in 15 patients on continuous ambulatory peritoneal dialysis (CAPD)

P Manzano-Gayosso1, F Hernández-Hernández, L J Méndez-Tovar

  • 1Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, México D.F. angelesmg@liceaga.facmed.unam.mx

Mycoses
|November 19, 2003
PubMed

Insights

Fungal peritonitis is common in continuous ambulatory peritoneal dialysis (CAPD) patients. This study identified Candida species and their antifungal resistance patterns, highlighting treatment challenges.

Area of Science:

  • Nephrology
  • Mycology
  • Infectious Diseases

Background:

  • Peritonitis is a frequent complication in patients with chronic renal failure undergoing continuous ambulatory peritoneal dialysis (CAPD).
  • Fungal peritonitis poses a significant challenge in CAPD patients, necessitating understanding of causative agents and their susceptibility profiles.
  • This study investigated the prevalence and antifungal susceptibility of fungal isolates in CAPD-associated peritonitis.

Observation:

  • A mycological study was conducted on peritoneal dialysis fluid samples from 165 CAPD patients presenting with peritonitis.
  • Direct microscopy, culture, and antifungal susceptibility testing were performed to identify fungal pathogens.
  • Ten Candida isolates were identified, with Candida albicans and Candida parapsilosis being the most prevalent species.

Findings:

  • Candida albicans, Candida parapsilosis, and Candida guilliermondii exhibited resistance to itraconazole.
  • Candida glabrata demonstrated resistance to both itraconazole and ketoconazole.
  • Aspergillus fumigatus and Acremonium sp. were also identified as causative agents in a subset of cases.

Implications:

  • The findings highlight the emergence of antifungal resistance in fungi causing peritonitis in CAPD patients.
  • Understanding these resistance patterns is crucial for guiding effective antifungal therapy and improving patient outcomes.
  • Further research into novel antifungal strategies and preventative measures for fungal peritonitis in CAPD is warranted.

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