Staphylococcal peritonitis in patients on continuous peritoneal dialysis

Area of Science:

• Nephrology
• Infectious Diseases
• Microbiology

Background:

• Peritonitis is a serious complication in patients undergoing continuous peritoneal dialysis (CPD).
• Staphylococcal infections are a leading cause of peritonitis in CPD patients.

Purpose of the Study:

• To investigate the characteristics and clinical outcomes of staphylococcal peritonitis in CPD patients.
• To differentiate the roles of Staphylococcus aureus and coagulase-negative staphylococci in peritonitis and its complications.

Main Methods:

• Retrospective analysis of 77 peritonitis cases in 35 CPD patients during 1984.
• Identification and characterization of staphylococcal species, including coagulase-negative staphylococci (CoNS) species, adherence, and exopolysaccharide production.
• Comparison of complication rates (tunnel infection, catheter removal) between S. aureus and CoNS infections.

Main Results:

• Staphylococci accounted for 71.4% of peritonitis cases (55/77).
• Staphylococcus aureus infections were associated with significantly higher rates of tunnel infections (P<0.01) and catheter removal (P<0.01) compared to CoNS.
• Staphylococcus epidermidis was the most common CoNS species (29/35).
• Peritonitis cases caused by CoNS lacking adherence and exopolysaccharides showed a trend towards more complications, though not statistically significant.
• No significant differences in antibiotic susceptibilities were observed between S. aureus and CoNS.

Conclusions:

• Staphylococcal peritonitis remains a significant cause of morbidity in CPD patients.
• Staphylococcus aureus poses a greater risk for severe complications, including tunnel infections and the need for catheter removal, compared to coagulase-negative staphylococci.
• While certain microbial properties of CoNS were studied, they did not appear to directly correlate with the incidence of complications in this cohort.