Analysis of the causative pathogens in uncomplicated CAPD-associated peritonitis: duration of therapy, relapses, and prognosis |
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| Authors: | T A Golper A I Hartstein |
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| Institution: | 1. Department of Nephrology, University Medical Center Ljubljana, Ljubljana, Slovenia;2. Medical Faculty, University of Ljubljana, Ljubljana, Slovenia;3. Clinic of Nephrology, Clinical Center of Serbia, Belgrade, Serbia;4. School of Medicine, University of Belgrade, Belgrade, Serbia;5. Department of Nephrology and Transplantation, Medical University of Sofia, Sofia, Bulgaria;6. Department of Nephrology and Dialysis, Clinical Hospital Center Rijeka, Rijeka, Croatia;7. Center of Urology, Dialysis and Kidney Transplantation, Fundeni Clinical Institute, Bucharest, Romania;8. Department of Nephrology, Dialysis and Renal Transplantation, CI Parhon Clinic Hospital, Lași, Romania;9. Clinic of Nephrology and Clinical Immunology, Clinical Center of Vojvodina, Novi Sad, Serbia;10. Medical Faculty, University of Novi Sad, Novi Sad, Serbia;11. Center for Transplantation of Solid Organs, Military Medical Academy, Belgrade, Serbia;12. Clinic of Nephrology, Clinical Center of Niš, Niš, Serbia;13. Faculty of Medicine, University of Niš, Niš, Serbia;14. Department of Dialysis, Clinical Hospital Center Osijek, Osijek, Croatia;15. Faculty of Medicine, University Josip Juraj Strossmayer Osijek, Osijek, Croatia;p. Astellas Pharma, D. O. O., Ljubljana, Slovenia;q. Rho Sigma, Ljubljana, Slovenia;r. Formerly Astellas D. O. O., Zagreb, Croatia;s. Formerly Astellas Pharma, D. O. O., Ljubljana, Slovenia;t. Division of Nephrology, University Hospital Merkur, Zagreb, Croatia |
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| Abstract: | We analyzed the frequency with which certain bacteria caused uncomplicated peritonitis in an adult continuous ambulatory peritoneal dialysis (CAPD) program that continued patients on this modality of therapy despite frequent infections. All infections were treated with a commonly employed 10- to 14-day course of narrow spectrum intraperitoneal antibiotics. Although the distribution of bacterial pathogens was similar to previous reports (coagulase-negative staphylococci, 43%; Staphylococcus aureus, 13%), we observed no episodes of fungal peritonitis. Twenty percent of our infections were associated with either "no specimens obtained" or "no growth," a finding similar to the CAPD registry. When the data were available, two thirds of all infections were caused by the same pathogen (genus and species) as in the most immediately preceding infection. Twenty-two of 96 episodes of uncomplicated peritonitis occurred within three weeks of a preceding infection. In all 11 cases where organisms were isolated from both paired episodes, the infecting agent was the same as in the preceding infection and was a staphylococcus. This high rate of apparent relapse and the absence of fungal infections may relate to our treatment protocol and possible explanations are discussed. Lastly, the occurrence of coagulase-negative staphylococcal peritonitis is a harbinger of future episodes of peritonitis caused by a variety of organisms. |
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