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[Peritonitis in intermittent peritoneal dialysis: microbiological aspects and the antibiogram]
Abstract:
Peritonitis is the most frequent complication in patients on peritoneal dialysis and bacteria are the major causative agents. Initial antibiotic therapy may be "blind" but the antimicrobial agent used should be related to the infecting organism and its sensitivities. This study was initiated in order to evaluate the microbiological characteristics and sensitivity of bacteria isolated from pre and post peritoneal dialysis effluents. Positive growth of microorganisms was observed in 52 out of 503 cultures. Staphylococcus aureus and Staphylococcus epidermidis were identified most frequently (29 per cent each). Antibiograms showed high sensitivity to aminoglycosides (netilmicin and amikacin) and to second and third generation cephalosporin. Vancomycin and netilmicin were the best choices for Staphylococcal infection. A high bacterial resistance to ampicillin, co-trimoxazole, cephalothin and gentamicin was verified. Characteristics of organisms causing peritonitis in patients on intermittent peritoneal dialysis is very important, for selection of the initial antibiotic therapy.
Insights
Peritonitis in peritoneal dialysis patients is often bacterial. Staphylococcus species are common, showing sensitivity to vancomycin and netilmicin, but resistance to ampicillin.
Area of Science:
- Microbiology
- Nephrology
- Infectious Diseases
Context:
- Peritonitis is a frequent complication for patients undergoing peritoneal dialysis.
- Bacterial infections are the primary cause of peritonitis in this population.
- Effective initial antibiotic therapy requires understanding local microbial patterns and sensitivities.
Purpose:
- To analyze the microbiological profiles of bacteria causing peritonitis in peritoneal dialysis patients.
- To determine the antibiotic sensitivity patterns of isolated microorganisms.
- To inform optimal empirical antibiotic selection for peritonitis treatment.
Summary:
- This study examined 503 peritoneal dialysis effluent cultures, identifying microorganisms in 52 instances.
- Staphylococcus aureus and Staphylococcus epidermidis were the most prevalent bacteria (29% each).
- High sensitivity was observed for netilmicin, amikacin, and later-generation cephalosporins, while resistance to ampicillin, co-trimoxazole, cephalothin, and gentamicin was noted.
Impact:
- Findings highlight the importance of characterizing causative organisms and their antibiotic susceptibilities for effective peritonitis management.
- Results guide the selection of appropriate initial antibiotic regimens, potentially improving patient outcomes.
- Understanding resistance patterns is crucial for antimicrobial stewardship in peritoneal dialysis.