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Bacteria on catheters in patients undergoing peritoneal dialysis
Maria Pihl1, Julia R Davies, Ann-Cathrine Johansson
1Department of Oral Biology, Faculty of Odontology, Malmö, Sweden.
Background:
Peritonitis is the leading cause of morbidity for peritoneal dialysis (PD) patients, and microbial biofilms have previously been identified on catheters from infected patients. However, few studies of catheters from patients without clinical signs of infection have been undertaken. The aim of the present study was to investigate the extent to which bacteria are present on catheters from PD patients with no symptoms of infection.
Methods:
Microbiologic culturing under aerobic and anaerobic conditions and confocal laser scanning microscopy were used to determine the distribution of bacteria on PD catheters from 15 patients without clinical signs of infection and on catheters from 2 infected patients. The 16S rRNA gene sequencing technique was used to identify cultured bacteria.
Results:
Bacteria were detected on 12 of the 15 catheters from patients without signs of infection and on the 2 catheters from infected patients. Single-species and mixed-microbial communities containing up to 5 species were present on both the inside and the outside along the whole length of the colonized catheters. The bacterial species most commonly found were the skin commensals Staphylococcus epidermidis and Propionibacterium acnes, followed by S. warneri and S. lugdunensis. The strains of these micro-organisms, particularly those of S. epidermidis, varied in phenotype with respect to their tolerance of the major classes of antibiotics.
Conclusions:
Bacteria were common on catheters from patients without symptoms of infection. Up to 4 different bacterial species were found in close association and may represent a risk factor for the future development of peritonitis in patients hosting such micro-organisms.
Insights
Bacteria are frequently found on peritoneal dialysis (PD) catheters, even in patients without infection symptoms. This presence of microbial communities, including common skin bacteria, may increase the risk of developing peritonitis.
Area of Science:
- Nephrology
- Microbiology
- Medical Devices
Background:
- Peritonitis is a major complication for patients undergoing peritoneal dialysis (PD).
- Microbial biofilms are known to form on PD catheters in infected patients.
- Limited research exists on bacterial presence on catheters from asymptomatic PD patients.
Purpose of the Study:
- To investigate the prevalence and distribution of bacteria on PD catheters from patients without clinical signs of infection.
- To identify bacterial species colonizing these catheters and assess their potential association with peritonitis risk.
Main Methods:
- Culturing techniques (aerobic and anaerobic) and confocal laser scanning microscopy were employed.
- PD catheters from 15 asymptomatic and 2 infected patients were analyzed.
- 16S rRNA gene sequencing was used for bacterial identification.
Main Results:
- Bacteria were detected on 12 of 15 catheters from asymptomatic patients and both infected patients.
- Colonization occurred on both inner and outer catheter surfaces, with single or mixed species (up to 5).
- Commonly identified bacteria included Staphylococcus epidermidis, Propionibacterium acnes, S. warneri, and S. lugdunensis, with varying antibiotic tolerance.
Conclusions:
- Bacteria are common on PD catheters even in the absence of infection symptoms.
- The presence of multiple bacterial species on catheters may represent a significant risk factor for future peritonitis development.
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