Related Experiment Videos
[Peritoneal complications of continuous ambulatory peritoneal dialysis]
E Stramignoni1, S Maffei, F Bonello
1Istituto di Nefro-Urologia, Università di Torino.
Abstract:
Aim of this work is an analysis of the clinical and microbiological aspects in 205 peritonitis episodes occurred in 156 patients admitted on peritoneal dialysis from January 1980 to December 1989. The evaluation of causative organisms shows a high prevalence of Gram+ organisms (60% of cases), while Gram- organisms are responsible for 16% of peritonitis episodes and fungi for 4%. No cultural growth was observed in 13% of the cases, while more than one organism occurred in 7%. Peritonitis incidence decreased from one episode every 3.9 patient months during 1980-81 to one every 33.6 patient months during 1988-89. This improvement is especially related to the employment of Y-set connection system and to the sterilization of connection lines by amuchina. From 1984 Y-set was used in each of the new patients admitted on CAPD. After its employment peritonitis incidence decreased from one episode every 6.2 patient months to one every 29 patient months. In our experience vancomycin i.v. proved to be effective and well tolerated. In no case a persistence of infectious disease was observed and no catheter was removed.
Insights
Peritonitis in peritoneal dialysis patients decreased significantly with the Y-set connection system and amuchina sterilization. Vancomycin IV was an effective treatment for these Gram-positive infections.
Area of Science:
- Nephrology
- Infectious Diseases
- Clinical Microbiology
Context:
- Peritonitis is a significant complication in patients undergoing peritoneal dialysis (PD).
- This study analyzes clinical and microbiological data from a decade of PD peritonitis cases.
- Understanding causative agents and incidence trends is crucial for improving patient outcomes.
Purpose:
- To analyze the clinical and microbiological features of 205 peritonitis episodes in 156 peritoneal dialysis patients.
- To evaluate the impact of the Y-set connection system and amuchina sterilization on peritonitis incidence.
- To assess the efficacy and tolerance of vancomycin for treating peritonitis.
Summary:
- Gram-positive organisms were the predominant cause of peritonitis (60%), followed by Gram-negative (16%) and fungi (4%).
- Peritonitis incidence dramatically decreased from 1 episode/3.9 patient-months to 1 episode/33.6 patient-months over the study period.
- The introduction of the Y-set connection system and amuchina sterilization significantly reduced peritonitis rates, particularly in continuous ambulatory peritoneal dialysis (CAPD) patients.
Impact:
- Implementation of the Y-set system and improved sterilization techniques led to a substantial reduction in peritonitis episodes.
- Vancomycin intravenous administration was found to be effective and well-tolerated, with no cases of persistent infection or catheter removal.
- These findings highlight the importance of infection control measures in PD and effective antibiotic strategies.