Peritonitis in patients on continuous ambulatory peritoneal dialysis. A changing scene
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Abstract:
Peritonitis is a serious and common complication in patients treated with continuous ambulatory peritoneal dialysis (CAPD). This work reports the experiences of this complication in 50 patients treated with CAPD for a total time of 844 months. 129 episodes were observed. Coagulase-negative staphylococci were found to be the causative organisms in 57% of the cases. Most episodes were acquired without any evident cause when CAPD was performed at home. Nine episodes were suspected to be the result of bacterial leakage through the intestinal wall. Six of them occurred in patients receiving corticosteroids. During the study period an increasing number of episodes of peritonitis were caused by organisms with multiple resistance to antibiotics. Thus, the microbiological spectrum in CAPD-related peritonitis must constantly be surveyed so that proper measures, e.g. regarding the choice of antibiotics used, can be taken when a change is observed.
Insights
Peritonitis is a common complication for patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Most cases were caused by coagulase-negative staphylococci, with increasing antibiotic resistance observed.
Area of Science:
- Nephrology
- Infectious Diseases
- Dialysis
Background:
- Peritonitis is a significant complication for patients on continuous ambulatory peritoneal dialysis (CAPD).
- Understanding the causative agents and trends is crucial for effective management.
Purpose of the Study:
- To report on the experience of peritonitis in CAPD patients.
- To identify common pathogens and observe trends in antibiotic resistance.
Main Methods:
- Retrospective analysis of 129 peritonitis episodes in 50 CAPD patients over 844 months.
- Microbiological analysis to identify causative organisms.
Main Results:
- Coagulase-negative staphylococci were the most frequent cause (57%).
- Many episodes occurred without a clear cause during home CAPD.
- Increasing antibiotic resistance among causative organisms was noted.
- Bacterial leakage from the intestinal wall was suspected in nine episodes, particularly in patients on corticosteroids.
Conclusions:
- Continuous monitoring of the microbiological spectrum in CAPD-related peritonitis is essential.
- This surveillance informs antibiotic selection and treatment strategies.
- Prompt identification and management of peritonitis are critical for patient outcomes.