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[Pathogenic bacteria and drug resistance in peritoneal dialysis related peritonitis]

Weisheng Peng1, Qiaoling Zhou, Xiang Ao

  • 1Department of Nephrology, Central South University, Changsha, China.

Zhong Nan Da Xue Xue Bao. Yi Xue Ban = Journal of Central South University. Medical Sciences
|January 3, 2013
PubMed
Abstract

Insights

Gram-positive bacteria are the most common cause of continuous ambulatory peritoneal dialysis (CAPD) peritonitis. For empirical treatment, consider cefazolin with piperacillin/tazobactam or cepoperazon/sulbactam for better outcomes.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Microbiology

Context:

  • Peritonitis is a serious complication of continuous ambulatory peritoneal dialysis (CAPD).
  • Understanding causative pathogens and their antibiotic resistance is crucial for effective management.
  • This study reviews cases from Xiangya Hospital (2007-2011).

Purpose:

  • To identify the primary pathogens responsible for CAPD-related peritonitis.
  • To analyze the antibiotic resistance patterns of these pathogens.
  • To evaluate the clinical outcomes of CAPD peritonitis treatments.

Summary:

  • A retrospective analysis of 78 CAPD peritonitis cases revealed gram-positive bacteria as the most frequent pathogens (58.18%), followed by gram-negative bacteria (32.72%) and fungi (9.09%).
  • Key pathogens included coagulase-negative staphylococcus, Staphylococcus aureus, and Escherichia coli.
  • Antibiotic resistance patterns indicated linezolid, teicoplanin, and vancomycin were effective against gram-positive strains, while amikacin and imipenem showed low resistance in gram-negative strains. Cefazolin exhibited high resistance (83.33%).
  • Treatment outcomes included 80.77% cure rates, 14.1% transfers to hemodialysis, and 5.13% mortality.

Impact:

  • Findings guide empirical antibiotic selection for CAPD peritonitis, suggesting cefazolin combined with piperacillin/tazobactam or cepoperazon/sulbactam as preferable alternatives.
  • Highlights the need for ongoing surveillance of pathogen prevalence and resistance patterns in CAPD populations.
  • Informs clinical decision-making to improve patient outcomes and reduce complications associated with CAPD peritonitis.

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