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Fungal peritonitis in peritoneal dialysis: a 10 year retrospective analysis in a single center
1Department of Nephrology, Sisli Etfal Research and Education Hospital, Istanbul, Turkey. tanerbast@yahoo.com
Introduction:
Fungal peritonitis (FP) is a rare but serious complication in patients undergoing peritoneal dialysis (PD), and is associated with higher morbidity, mortality. We aimed to analyze the predisposing factors, etiological agents, outcome and treatment of FP in patients with PD.
Methodology:
We evaluated retrospectively all PD patients PD center between 2001 and 2011. Sixteen patients with FP were included into the study.
Results:
The clinical records of 16 patients with FP among 355 patients were reviewed for the clinical and laboratory data. Among 506 episodes of PD-related peritonitis in 10 years, we identified 16 episodes of FP. Median PD duration was 36.7±22.2 months. In 87.5% of patients had one or more previous episode of bacterial peritonitis that were treated with multiple broad-spectrum antibiotics. FP was primary infection in five patients, whereas eleven patients experienced FP during the course of treatment of bacterial peritonitis. Six patients died due to the fungal infection whereas others were transferred to haemodialysis.
Conclusions:
Treatment of bacterial peritonitis with broad spectrum antibiotics was an important risk factor predisposing to the development of FP. The catheter removal and initiation of antifungal therapy as soon as possible are obligatory in episode of FP because it is responsible from high mortality rate.
Insights
Broad-spectrum antibiotic treatment for bacterial peritonitis is a significant risk factor for fungal peritonitis (FP) in peritoneal dialysis (PD) patients. Early catheter removal and antifungal therapy are crucial for managing FP and reducing high mortality rates.
Area of Science:
- Nephrology
- Infectious Diseases
- Critical Care Medicine
Background:
- Fungal peritonitis (FP) is a rare but severe complication in patients undergoing peritoneal dialysis (PD).
- FP is associated with increased morbidity and mortality rates.
- Understanding predisposing factors, causative agents, and treatment outcomes is crucial for patient management.
Purpose of the Study:
- To analyze predisposing factors for fungal peritonitis in PD patients.
- To identify etiological agents responsible for FP.
- To evaluate the treatment outcomes and mortality associated with FP in PD patients.
Main Methods:
- Retrospective evaluation of PD patients from 2001 to 2011.
- Inclusion of 16 patients diagnosed with fungal peritonitis.
- Review of clinical and laboratory data for identified FP cases.
Main Results:
- 16 episodes of FP identified among 506 PD-related peritonitis episodes over 10 years.
- 87.5% of FP patients had prior bacterial peritonitis treated with broad-spectrum antibiotics.
- High mortality rate observed, with 6 deaths directly attributed to fungal infection.
Conclusions:
- Treatment of bacterial peritonitis with broad-spectrum antibiotics is a key risk factor for developing FP.
- Prompt catheter removal and initiation of antifungal therapy are essential for managing FP.
- Aggressive management is necessary to mitigate the high mortality associated with fungal peritonitis in PD patients.
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