Related Experiment Video
Updated: Jun 12, 2026
06:27
A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice
Published on: July 20, 2022
Enterococcal peritonitis in children receiving chronic peritoneal dialysis.
Scott M Sutherland1, Steven R Alexander, Reinhard Feneberg
1Stanford University Medical Center, Department of Pediatrics, Division of Nephrology, 300 Pasteur Drive, Room G-306, Stanford, CA 94035, USA. suthersm@stanford.edu
Summary
Enterococcus causes about 6% of peritonitis in children on chronic peritoneal dialysis (CPD). Treatment outcomes are good despite antibiotic resistance, with cephalosporin regimens showing effectiveness.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Dialysis
Background:
- Peritonitis is a frequent complication of chronic peritoneal dialysis (CPD), often leading to technique failure.
- Enterococcus is an infrequent cause of peritonitis in pediatric CPD patients, posing treatment challenges due to antibiotic resistance.
Purpose of the Study:
- To evaluate the incidence, clinical presentation, and outcomes of enterococcal peritonitis in children undergoing CPD.
- To assess the impact of antibiotic resistance patterns on treatment efficacy.
Main Methods:
- Data from 392 children with CPD experiencing 340 culture-positive peritonitis episodes (2001-2004) were analyzed from the International Pediatric Peritonitis Registry.
- Clinical characteristics, in vitro antibiotic resistance, and treatment responses were assessed.
Main Results:
- Enterococcus species accounted for 5.9% of culture-positive peritonitis episodes.
- No unique clinical features distinguished enterococcal peritonitis at presentation.
- Despite in vitro resistance to cephalosporins and 21% resistance to glycopeptides, all patients achieved full functional recovery, irrespective of empiric antibiotic choice.
Conclusions:
- Enterococci are a significant cause of peritonitis in pediatric CPD patients, requiring careful management.
- Clinical outcomes are favorable and not influenced by in vitro resistance patterns or initial antibiotic regimens, suggesting prompt recovery even with cephalosporin-based empiric therapy.
Related Concept Videos
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
01:25Peritoneal Dialysis III: Nursing Management
Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...
01:30Peritoneal Dialysis I: Introduction and Procedure
Peritoneal dialysis (PD) is a procedure that facilitates the exchange of solutes, waste products, electrolytes, and excess fluid between the blood in the peritoneal capillaries and a dialysis solution introduced into the peritoneal cavity.Principles of Peritoneal Dialysis (PD)Diffusion: Waste products such as urea and electrolytes move from high concentrations in the blood to low concentrations in the dialysate across the peritoneal membrane. This mechanism is driven by the concentration...
01:30Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis
Patients with end-stage renal disease (ESRD) or those experiencing drug overdose often require extracorporeal methods to eliminate accumulated drugs and metabolites. Hemoperfusion, hemofiltration, and dialysis are the primary techniques to rapidly remove harmful substances without disrupting the patient's fluid and electrolyte balance. For those with compromised renal function, dosage adjustments of concurrent medications may be necessary during extracorporeal drug removal.Dialysis is a process...
01:24Hemodialysis II: Procedure and Complications
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...