Differing prognostic significance of reinfection and relapse in CAPD peritonitis

All episodes of recurrent infection in a CAPD unit over a 26-monthperiod have been analysed to discover whether relapse and reinfectionhave different prognostic importance. Relapse and reinfectionwere distinguished by detailed microbiological investigation.Prognosis was expressed in terms of outcome of treatment andthe fate of the Tenckhoff catheter. Twenty-nine patients suffered recurrent infections (i.e. morethan one infection during a 12-month period). Nine (6 male,3 female, age range 42–73 years) had relapses, and 20(16 male, 4 female, age range 42–74 years) reinfections.The characteristics of the two groups of patients were indistinguishable. Relapse was of graver prognostic consequence: patients who relapsedwere significantly less likely to respond to antibiotic treatment(78% versus 20%) and have to have their catheters removed (78%versus 10%) than those with reinfections. Thus it is importantto differentiate relapse from reinfection in CAPD peritonitis.In addition to being helpful for the management of individualpatients, this is essential if results of therapeutic trialsare to be interpreted correctly.