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Acinetobacter peritoneal dialysis peritonitis: a changing landscape over time.

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Acinetobacter peritonitis in peritoneal dialysis (PD) patients is rare but evolving. This study highlights changes in causes and suggests improved sterility measures are needed to reduce PD peritonitis incidence.

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Area of Science:

  • Infectious Diseases
  • Nephrology
  • Microbiology

Background:

  • Acinetobacter species are increasingly significant in healthcare settings due to antibiotic resistance.
  • Clinical data on Acinetobacter peritonitis in peritoneal dialysis (PD) patients remain scarce.
  • This study addresses the limited understanding of Acinetobacter peritonitis in PD patients.

Purpose of the Study:

  • To analyze the clinical features, microbiological data, and outcomes of Acinetobacter peritonitis in PD patients.
  • To identify temporal trends in the incidence and origins of Acinetobacter PD peritonitis.
  • To evaluate the impact of changes over time on patient management and outcomes.

Main Methods:

  • Retrospective review of all PD peritonitis episodes caused by Acinetobacter from 1985 to 2012.
  • Stratification of data into two periods: before and after the year 2000.
  • Analysis of clinical characteristics, causative pathogens, treatment responses, and outcomes.

Main Results:

  • Acinetobacter species caused 26 PD peritonitis episodes (3.5%) in 25 patients.
  • Acinetobacter baumannii was the predominant species after 2000, with increased episodes linked to exchange sterility breaks.
  • All isolates remained susceptible to cefepime, fluoroquinolones, and aminoglycosides; 46% of patients required hospitalization.

Conclusions:

  • Temporal shifts in Acinetobacter peritonitis microbiology and origins indicate an evolving trend in PD patients.
  • Enhanced technique re-education and sterility maintenance are crucial for reducing Acinetobacter peritonitis incidence.
  • The study underscores the need for ongoing surveillance and adaptive management strategies for PD-associated infections.