Epidemiology of peritonitis in continuous ambulatory peritoneal dialysis: single center experience.
- Author:
Eun Ah HWANG
1
;
Jung Hoon SUNG
;
Seung Yeup HAN
;
Sung Bae PARK
;
Hyun Chul KIM
;
Hyung Tae KIM
;
Won Hyun CHO
Author Information
1. Department of Internal Medicine and General Surgery, Keimyung University School of Medicine and Dongsan Kidney Institute, Daegu, Korea. k780121@dsmc.or.kr
- Publication Type:Original Article
- Keywords:
Peritonitis;
Peritoneal Dialysis;
Continuous Ambulatory
- MeSH:
Anti-Bacterial Agents;
Ascitic Fluid;
Catheters;
Coagulase;
Epidemiology*;
Escherichia coli;
Fungi;
Humans;
Incidence;
Klebsiella;
Mortality;
Patient Education as Topic;
Peritoneal Dialysis;
Peritoneal Dialysis, Continuous Ambulatory*;
Peritonitis*;
Pseudomonas;
Retrospective Studies;
Sepsis;
Staphylococcus;
Staphylococcus aureus
- From:Korean Journal of Medicine
2002;63(3):314-321
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Peritonitis is one of the major complication leading to mortality and technique failure in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). We have examined the incidence and etiology of CAPD peritonitis at Keimyung University Dongsan medical center. METHODS: Between January 1996 and December 2000, 238 new patients received peritoneal dialysis and were reviewed retrospectively. RESULTS: In 238 patients, 109(45.8%) patients experienced peritonitis and a total of 192 episodes of peritonitis has occurred during study period. The overall incidence of peritonitis during CAPD averaged 0.94/patient-year and there was no essential change during the last five years. The most common causative organism was Gram positive organism (41.7%), followed by Gram negative organism (14.1%), and fungus (2%). In Gram positive organism, Staphylococcus aureus (47.5%) was the most common microorganism, followed by coagulase negative Staphylococcus (23.5%), Streptococci (7.5%), and Enterococci (5.5%). Gram negative organism were Acinetobactor (29.6%), Escherichia coli (18.5%), Klebsiella (18.5%) and Pseudomonas (7.4%) in decreasing order of frequency. With the use Bactec blood culture system for peritoneal fluid culture since April 2000, the culture yield has been improved significantly than before (52.5% vs 72.2%, p < 0.05). Peritonitis was cured in 164 cases (85.6%) with the administration of antibiotics. However catheters had to be removed in 23 cases (11.8%). Exit-site infection was more frequent in catheter removal group than in catheter retaining group (17.4% vs 4.7%, p < 0.05). The CAPD failure occured in 28 patients during study period, and peritonitis was the major reason for technique failure (82.1%). The catheter removal rate was significantly higher in the patients with peritonitis than those without peritonitis (55.0% vs 30.2%, p < 0.05). There were six deaths during study period. Septicemia associated with peritonitis accounted for the half of the mortality. CONCLUSION: Better exit-site care and continuing patient education is needed the incidence of peritonitis and peritonitis related mortality in CAPD patient.
