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Isolation of organisms in CAPD peritonitis: a comparison of two techniques
Abstract:
The identification of organisms is important in the treatment of continuous ambulatory peritoneal dialysis (CAPD) peritonitis. We compared two techniques for isolating organisms in CAPD peritonitis. Clinical and microbiologic data on all episodes of peritonitis from 1991-1993 were prospectively recorded. The isolation of organisms from 77 episodes of peritonitis was done using the conventional centrifugation culture method from 1991-1992; the isolation of organisms from 121 episodes of peritonitis was done using the BACTEC method from 1992-1993. The total culture-positive rates were 75% for the BACTEC technique and 58% for the conventional technique (p = 0.05), with a higher isolation rate for gram-negative organisms (36% vs 18%, p < 0.05). In the isolation of organisms from new episodes of peritonitis, the culture-positive rates were significantly higher for the BACTEC than for the conventional technique (82% vs 55%, p < 0.01). The recovery rates of organisms for both techniques were similar for relapse peritonitis. The treatment outcomes of CAPD peritonitis for the two technique groups, and for the culture-positive and culture-negative groups were not significantly different. In conclusion, the BACTEC method yielded a higher rate of positive cultures for CAPD peritonitis, but did not affect treatment outcome of the infections.
Insights
The BACTEC method significantly improves organism identification in continuous ambulatory peritoneal dialysis (CAPD) peritonitis compared to conventional methods. However, this enhanced diagnostic yield did not alter patient treatment outcomes.
Area of Science:
- Nephrology
- Clinical Microbiology
- Infectious Diseases
Background:
- Accurate organism identification is crucial for effective treatment of continuous ambulatory peritoneal dialysis (CAPD) peritonitis.
- Comparing diagnostic techniques is essential for optimizing patient care in CAPD peritonitis.
Purpose of the Study:
- To compare the efficacy of the BACTEC method versus conventional centrifugation culture for isolating organisms in CAPD peritonitis.
- To assess the impact of different isolation techniques on treatment outcomes.
Main Methods:
- Prospective recording of clinical and microbiologic data for CAPD peritonitis episodes from 1991-1993.
- Comparison of organism isolation rates using conventional centrifugation (1991-1992) and BACTEC (1992-1993) methods.
- Analysis of culture-positive rates for new and relapse peritonitis episodes.
Main Results:
- The BACTEC method achieved significantly higher total culture-positive rates (75% vs. 58%) and higher isolation rates for gram-negative organisms.
- For new peritonitis episodes, BACTEC showed significantly higher culture-positive rates (82% vs. 55%) compared to the conventional technique.
- Organism recovery rates were similar for both techniques in relapse peritonitis.
Conclusions:
- The BACTEC method offers a superior diagnostic yield for identifying organisms in CAPD peritonitis.
- Despite improved organism detection, the BACTEC method did not significantly impact the treatment outcomes of CAPD peritonitis infections.