Related Experiment Videos
Peritonitis in continuous ambulatory peritoneal dialysis: analysis of an 8-year experience
Abstract:
Experiences with peritonitis in a continuous ambulatory peritoneal dialysis (CAPD) program at a single center over 8 years were reviewed. Home-acquired peritonitis rates have been less than 1 episode per patient year since 1982. Gram-positive organisms continue to account for most episodes in a similar proportion. Actual known contamination could be pinpointed in only 7.4% of cases, but was strongly suspected in 35.8% of episodes. Exit site and/or tunnel infections were thought to have caused 20% of the cases. Intrinsic peritonitis probably accounted for 10.5%. Recurrence of peritonitis with the same organisms following cessation of antibiotics represented only 2.1% of cases.
Insights
Continuous ambulatory peritoneal dialysis (CAPD) patients experienced low peritonitis rates, with Gram-positive bacteria most common. Contamination was rarely pinpointed, but infections often stemmed from exit sites or intrinsic causes.
Area of Science:
- Nephrology
- Infectious Diseases
- Dialysis Medicine
Background:
- Peritonitis is a significant complication in continuous ambulatory peritoneal dialysis (CAPD).
- Understanding the sources and patterns of peritonitis is crucial for improving patient outcomes in CAPD programs.
Purpose of the Study:
- To review and analyze the experiences with peritonitis in a single-center CAPD program over an 8-year period.
- To identify the common causative organisms, sources of infection, and recurrence rates of peritonitis in CAPD patients.
Main Methods:
- Retrospective review of peritonitis cases in a CAPD program.
- Analysis of infection rates, causative organisms, suspected contamination sources, and recurrence.
- Categorization of peritonitis causes including contamination, exit site infections, and intrinsic factors.
Main Results:
- Peritonitis rates remained below 1 episode per patient-year since 1982.
- Gram-positive organisms were the predominant cause of peritonitis episodes.
- Known contamination was identified in only 7.4% of cases, with suspected contamination in 35.8%.
- Exit site/tunnel infections accounted for 20% of cases, and intrinsic peritonitis for 10.5%.
- Peritonitis recurrence with the same organism was low at 2.1%.
Conclusions:
- CAPD programs can achieve low peritonitis rates with vigilant management.
- Gram-positive bacteria are the primary pathogens, but pinpointing contamination sources remains challenging.
- Exit site infections and intrinsic factors are significant contributors to peritonitis in CAPD, necessitating targeted prevention strategies.