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Continuous ambulatory peritoneal dialysis: factors influencing recovery of organisms from effluents

P A Howe1, A P Fraise

  • 1Public Health Laboratory, John Radcliffe Hospital, Oxford, England, UK.

Medical Laboratory Sciences
|April 1, 1991
PubMed

Insights

Delayed processing and antimicrobial agents in peritoneal dialysate reduce positive culture yields for continuous ambulatory peritoneal dialysis peritonitis. Optimizing specimen handling is crucial for accurate diagnosis.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Clinical Microbiology

Background:

  • Continuous ambulatory peritoneal dialysis (CAPD) peritonitis is a common complication.
  • Accurate and timely diagnosis of CAPD peritonitis relies on peritoneal dialysate cultures.
  • Suboptimal culture yields can delay appropriate treatment.

Purpose of the Study:

  • To investigate factors contributing to low positive culture yields in CAPD peritonitis.
  • To identify reasons for false-negative results in peritoneal fluid cultures.

Main Methods:

  • Sixty peritoneal dialysate specimens from CAPD patients were cultured.
  • Specimens were analyzed for processing delays and presence of antimicrobial substances.
  • A broth dilution method was evaluated for its impact on culture yield.

Main Results:

  • A high positivity rate of 78% (47/60) was observed.
  • Negative culture results were significantly associated with delayed specimen processing.
  • Antimicrobial substances in the dialysate were also linked to negative culture outcomes.
  • Broth dilution did not substantially improve the positive yield.

Conclusions:

  • Delayed processing and antimicrobial contamination are key factors reducing diagnostic yield in CAPD peritonitis cultures.
  • Standard culture methods are effective when specimens are processed promptly and free from inhibitory substances.
  • Further research into optimizing culture techniques for contaminated samples may be warranted.

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