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- Title
MICROBIOLOGICAL PROFILE OF CAPD PERITONITIS: 10 YEARS OF EXPERIENCE.
- Authors
Dejan, Pilčević; Maksić, Đoko; Jovanović, Dragan; Kovačević, Zoran; Terzić, B.; Petrović, M.; Paunić, Z.
- Abstract
INTRODUCTON: Peritoneal dialysis presents a significant method for treatment of acute renal failure during mass disasters. The main complication of this method is CAPD peritonitis, so early diagnosis and empirical treatment have crucial importance for its success. Recomendationes of International society of peritoneal dialysis (ISPD) are that level of CAPD peritonitis should be less than 1 episode /18 patients months. OBJECTIVES: To identify the most common infecting organism in PD -associated peritonitis, their antibiotic susseptibility to empirical treatment, evaluates the clinical outcomes, the survival of the technique METHODS: Clinical records and reports reliable evaluated from the patients who attended the PD program in Military Medical Academy since 2001 to 2010. We analyzed 186 patients [98 male, 88 female; mean age 58,4 +/- 12,4 years /range 18-85 years/}. A total of 147 peritonitis episodes were identified. Diagnosis of peritonitis was made based on clinical signs of inflamation, number of white blood cells and culture fron the PD fluid. Dyalisate specimens were obtained from all cases and were examined for microbilogic culture and resistance. RESULTS: The incidence of peritonitis in our centre was 1 episode / 29,86 patient months. Culture revealed: a possitive culture in the peritoneal fluid was found in 87,07 % of the peritonitis episodes. A single gram (+) organism was found in 71,88 % of the positive culture cases: Staphylococus coag. negative 55/92 (59,78%), Staphylococcus aureus 11/92 (11,96%), Streptococcus spp 10/92 (10,87%), Enterococcus 8/92(8,69%), Coryneform.. 8/92 (8,69%). Methicillin-resistant staphylococcus was found in 26/66 (39,39%); Staphylococus coag. negative 22/55; S.aureus 4/11. There was 2 cases vankomycin resistence staphylococcus aureus and 2 cases vankomycin resistence enterococcus. A single gram (-) organism was found in 21,88 % of the positive culture cases:E.colli 10/28 (35,71%), Acinetobacter 6/28 (21,43%), Klebsiella 4/28 (14,28%), Proteus 4/28(14,28%), Pseudomonas aeruginosa3/28 (10,71%), Stenotrophomonas 1/28 (3,59%). Polymicrobial peritonitis occurred in 6 cases (4,67%) and fungal peritonitis in 2 cases (1,57%) . The overall cure rate was 87.4 %, relapsing peritonitis occurred in 8 patients, 10 patients required transfer to hemodialysis. There were 3 peritonitis -related deaths. CONCLUSION‟s: Gram positive microorganisms are the most common finding in a CAPD peritonitis in our hospital with important level of vankomycin resistence microorganisms. That RESULTS with bacterial antibiotic sussceptibilitys resulted our center-based guidelines for the initial empirical treatment of PD - associated peritonitis.
- Publication
Balkan Military Medical Review, 2013, Vol 16, p160
- ISSN
1107-6275
- Publication type
Article