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Polymicrobial peritonitis in patients on continuous peritoneal dialysis.

J L Holley1, J Bernardini, B Piraino

  • 1Renal-Electrolyte Division, University of Pittsburgh, PA 15213.

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|February 1, 1992
PubMed
Summary

Polymicrobial peritonitis, an infection with multiple microbes, is more common in Black patients undergoing continuous peritoneal dialysis. While often treatable without catheter removal, it’s linked to higher infection rates.

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Area of Science:

  • Nephrology
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Limited data exists on polymicrobial peritonitis in continuous peritoneal dialysis (CPD) patients.
  • Understanding its characteristics, outcomes, and risk factors is crucial for managing CPD-related infections.

Purpose of the Study:

  • To investigate the characteristics, outcomes, and risk factors of polymicrobial peritonitis in patients on CPD.
  • To identify patient populations at higher risk for this condition.

Main Methods:

  • Retrospective review of 43 episodes of polymicrobial peritonitis in 39 CPD patients over 11.5 years.
  • Analysis of peritonitis episodes, causative organisms, associated infections, treatment outcomes, and patient demographics.

Main Results:

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  • Polymicrobial peritonitis accounted for 9% of all peritonitis episodes.
  • Staphylococcus aureus was present in 33% of cases. Black patients showed a higher incidence (P < 0.005).
  • Higher rates of tunnel and overall peritonitis were observed. 60% of cases were treated successfully without catheter removal.

Conclusions:

  • Polymicrobial peritonitis in CPD patients often lacks gram-negative organisms and may involve catheter infections.
  • Black patients are at increased risk for polymicrobial peritonitis for unknown reasons.
  • While associated with more catheter removals, successful non-surgical treatment is achievable in many cases.