Continuous Ambulatory Peritoneal Dialysis-Related Peritonitis Associated with Lancefield Group G Beta-Hemolytic Streptococcus: Report of Two Cases Requiring Tenckhoff Catheter Removal

Insertion of Tenckhoff catheters for continuous ambulatory peritoneal dialysis by nephrologists remains uncommon in most developing countries, including Indonesia. The aim of this study is to describe our experience on a simple technique of Tenckhoff catheter insertion by a nephrologist called the Bandung method. We conducted a retrospective observational study from May 2012 until December 2018 in 230 patients with end-stage renal disease using the Bandung method, a blind percutaneous insertion approach modified from the Seldinger technique. Early complications after insertion were assessed. The mean age of patients was 47.28 years (range 14–84 years). Within 1 month after insertion, complications occurred in 34 patients: 13 (5.7%) malposition, 8 (3.5%) omental trapping, 6 (2.6%) outlow failure, 3 (1.3%) peritonitis, 1 (0.4%) catheter infections, 1 (0.4%) bleeding, 1 (0.4%) kinking, and 1 (0.4%) hernia. None of these complications led to catheter removal. One patient experienced a late (>1 month) post-insertion complication of malposition that could not be repositioned and led to catheter removal. The Bandung method is a simple, cost effective, and minimally invasive technique for Tenckhoff catheter insertion that is associated with the same rate of complications compared to other techniques. This technique may useful for application in developing countries.

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Pulmonary Infections Caused by Lancefield Group A Beta-Hemolytic Streptococcus

Pulmonary Infections and Immunity - Infectious Agents and Pathogenesis ◽

10.1007/978-1-4899-1063-9_3 ◽

1994 ◽

pp. 51-62

Author(s):

Richard H. Goldstein ◽

Ellie J. C. Goldstein

Keyword(s):

Pulmonary Infections ◽

Hemolytic Streptococcus ◽

Beta Hemolytic Streptococcus ◽

Group A ◽

Lancefield Group

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Survival of 138 Surgically Placed Straight Double-Cuff Tenckhoff Catheters in Patients on Continuous Ambulatory Peritoneal Dialysis

Peritoneal Dialysis International ◽

10.1177/089686089301300312 ◽

1993 ◽

Vol 13 (3) ◽

pp. 224-227 ◽

Cited By ~ 19

Author(s):

Jochen Weber ◽

Thomas Mettang ◽

Eugen Hübel ◽

Thomas Kiefer ◽

Ulrich Kuhlmann

Keyword(s):

Peritoneal Dialysis ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Infectious Complications ◽

Catheter Survival ◽

Tenckhoff Catheter ◽

Mechanical Complications ◽

Unselected Patient ◽

Kaplan Meier ◽

History Of ◽

The Difference

Objective To determine the natural history of a surgically placed Tenckhoff catheter in patients on continuous ambulatory peritoneal dialysis (CAPD). Design Prospective 7–year study analyzing catheter survival of all catheters using the Kaplan-Meier life table methodology. Setting Teaching hospital, department of nephrology. Patients One hundred and fifteen unselected patients beginning CAPD. Interventions Removal of the catheter required for the following complications: exit-site or tunnel infections or relapsing peritonitis, outflow obstruction, pericatheter leak, and development of hernias. Main Outcome Measures Period between insertion and removal of the catheter. Results The cumulative survival of all catheters after 1,2, and 3 years of CAPD was 87%, 69% and 65%. Catheter survival of the first versus the second catheter after 1 year was significantly longer (p=0.03). The difference was not significant in relation to diabetes, age, and sex. Infectious complications caused 61% (n=19) of all 31 catheter failures, mainly due to tunnel infections caused by Staphylococcus aureus (n=12). “Mechanical” complications accounted for 49% (n=12) of catheter failures. Eight of 12 mechanical complications were outflow failures. Seven patients had to be transferred to hemodialysis. Conclusions The straight Tenckhoff catheter is a reliable peritoneal access device for CAPD in an unselected patient population.

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Peritonitis Caused by Monilia sitophila in a Patient Undergoing Peritoneal Dialysis

The International Journal of Artificial Organs ◽

10.1177/039139889601900403 ◽

1996 ◽

Vol 19 (4) ◽

pp. 218-220 ◽

Cited By ~ 4

Author(s):

A.E. Radix ◽

V.M. Bieluch ◽

C.W. Graeber

Keyword(s):

Peritoneal Dialysis ◽

Amphotericin B ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Fungal Peritonitis ◽

Common Cause ◽

Tenckhoff Catheter ◽

First Case ◽

Etiologic Agents ◽

Oral Itraconazole

Fungi have become an increasingly important cause of peritonitis in patients undergoing continuous ambulatory peritoneal dialysis. The most common cause of fungal peritonitis is Candida. However, in recent years unusual and “nonpathogenic” fungi have been reported as etiologic agents of CAPD-associated peritonitis. We are reporting the first case of CAPD-associated peritonitis caused by Monilia sitophila. This organism had previously been considered to be non-pathogenic, and a troublesome laboratory contaminant. Our patient was successfully managed with intravenous and intraperitoneal amphotericin B, followed by oral itraconazole, without removal of her Tenckhoff catheter.

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Severe Peritonitis during CAPD Due to Beta-hemolytic Streptococcus, Lancefield Group A

Peritoneal Dialysis International ◽

10.1177/089686088300300221 ◽

1983 ◽

Vol 3 (2) ◽

pp. 109-109 ◽

Cited By ~ 3

Author(s):

C. Dadone ◽

L. Bonoldi ◽

G. Giltri ◽

L. Vigore ◽

P. Mariani ◽

...

Keyword(s):

Hemolytic Streptococcus ◽

Beta Hemolytic Streptococcus ◽

Severe Peritonitis ◽

Group A ◽

Lancefield Group

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High Peritoneal Glucose Exposure Is Associated with Increased Incidence of Relapsing and Recurrent Bacterial Peritonitis in Patients Undergoing Peritoneal Dialysis

Blood Purification ◽

10.1159/000381663 ◽

2015 ◽

Vol 40 (1) ◽

pp. 72-78 ◽

Cited By ~ 3

Author(s):

Na Jiang ◽

Zhen Zhang ◽

Wei Fang ◽

Jiaqi Qian ◽

Shan Mou ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Independent Predictor ◽

Removal Rate ◽

Catheter Removal ◽

Cure Rate ◽

Complete Cure ◽

Bacterial Peritonitis ◽

Logistic Analysis ◽

Glucose Exposure

Aim: We investigated the association of peritoneal glucose exposure and dialysis exchange number with peritonitis outcome in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Methods: The first episodes of bacterial peritonitis were retrospectively analyzed in 187 CAPD patients. Peritoneal glucose exposure was calculated based on PD prescription at the onset of peritonitis. Results: Patients with peritoneal glucose exposure ≤140 g/day showed a higher and complete cure rate of peritonitis (66 vs. 51.7%, p = 0.047), lower occurrence of relapsing/recurrent peritonitis (10.0 vs. 21.8%, p = 0.026) and catheter removal (14.0 vs. 26.4%, p = 0.033). Patients who exchanged more than three times every day demonstrated marginally higher catheter removal rate (24.1 vs. 13.0%, p = 0.085). Logistic analysis indicated that peritoneal glucose exposure >140 g/day was an independent predictor for relapsing/recurrent peritonitis (RR: 1.959, p = 0.042). Conclusion: High peritoneal glucose exposure is associated with increased incidence of relapsing/recurrent peritonitis in CAPD patients.

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Feasibility of Resuming Peritoneal Dialysis after Severe Peritonitis and Tenckhoff Catheter Removal

Journal of the American Society of Nephrology ◽

10.1681/asn.v1341040 ◽

2002 ◽

Vol 13 (4) ◽

pp. 1040-1045

Author(s):

Cheuk-Chun Szeto ◽

Kai-Ming Chow ◽

Teresa Yuk-Hwa Wong ◽

Chi-Bon Leung ◽

Angela Yee-Moon Wang ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Catheter Removal ◽

Early Assessment ◽

Dialysis Adequacy ◽

Technique Survival ◽

Tenckhoff Catheter ◽

Success Group ◽

Severe Peritonitis ◽

Peritoneal Function

ABSTRACT. Published guidelines suggest that after an episode of severe peritonitis that requires Tenckhoff catheter removal, peritoneal dialysis can be resumed after a minimum of 3 wk. However, the feasibility of resuming peritoneal dialysis after Tenckhoff catheter removal remains unknown. One hundred patients were identified with peritonitis that did not respond to standard antibiotic therapy in a specific center. Their clinical course was reviewed; in all of them, Tenckhoff catheters were removed and reinsertion was attempted at least 4 wk later. In 51 patients, the Tenckhoff catheter was successfully reinserted and peritoneal dialysis was resumed (success group). In the other 49 pateints, reinsertion failed and the patient was put on long-term hemodialysis (fail group). The patients were followed for 18.5 ± 16.8 mo. The overall technique survival was 30.8% at 24 mo. In the success group, 11 patients were changed to long-term hemodialysis within 8 mo after their return to continuous ambulatory peritoneal dialysis. In the fail group, 18 of the 20 deaths occurred within 12 mo after conversion to long-term hemodialysis. After resuming peritoneal dialysis, there was a significant decline in net ultrafiltration volume (0.38 ± 0.16 to 0.21 ± 0.19 L; P = 0.03) and a trend of rise in dialysate-to-plasma ratios of creatinine at 4 h (0.664 ± 0.095 to 0.725 ± 0.095; P = 0.15). Forty-five patients (88.2%) required additional dialysis exchanges or hypertonic dialysate to compensate for the loss of solute clearance or ultrafiltration, although there was no significant change in dialysis adequacy or nutritional status. It was concluded that after an episode of severe peritonitis that required Tenckhoff catheter removal, only a small group of patients could return to peritoneal dialysis. An early assessment of peritoneal function after Tenckhoff catheter reinsertion may be valuable.

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CONTINUOUS AMBULATORY PERITONEAL DIALYSIS USING STRAIGHT TYPE VS COILED TYPE TENCKHOFF CATHETER IN END-STAGE RENAL DISEASE PATIENTS AT SARDJITO HOSPITAL

Indonesian Journal of Urology ◽

10.32421/juri.v18i1.67 ◽

2011 ◽

Vol 18 (1) ◽

Author(s):

Eka Yudha Rahman ◽

Sungsang Rochadi ◽

Trisula Utomo

Keyword(s):

Peritoneal Dialysis ◽

Renal Disease ◽

Continuous Ambulatory Peritoneal Dialysis ◽

End Stage Renal Disease ◽

Chi Square ◽

Catheter Migration ◽

Tenckhoff Catheter ◽

Significant Difference ◽

Stage Renal Disease ◽

End Stage

Objective: The purpose of this study was to compare straight type versus coiled type Tenckhoff catheter for continuous ambulatory peritoneal dialysis (CAPD) in end stage renal disease. Material & method: A prospective cohort study enrolled end-stage renal disease patients undergoing CAPD for renal replacement therapy in Urology and Nephrology Department, Sardjito Hospital from January to December 2007. Identity and type of Tenckhoff catheter were recorded. Patients were grouped into two groups who used straight type catheter and coiled type catheter for CAPD, then observed for post-operative complication. Statistical analysis was done using SPSS 14.0 with chi-square test. Results: There were 27 patients included in this study. The cause of end-stage renal disease was mostly DM and hypertension. The most common complication after operation was catheter obstruction (9 patients). Another complication was intraabdominal bleeding (1 patient), and catheter migration (1 patient). In patients with straight catheter (20 patients), there were 8 patients (40%) with complication. In patients with coiled catheter (7 patients), there were 3 patients (42%) with complication. There was no significant difference in complications between straight and coiled catheter groups (p = 0,895). Conclusion: The result of this study revealed that no significant difference in complication between straight and coiled catheter for CAPD in end-stage renal disease patients

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Acute osteomyelitis/ pyoarthritis caused by Lancefield Group F beta-hemolytic streptococcus

The Journal of the American Osteopathic Association ◽

10.1515/jom-1982-820725 ◽

1982 ◽

Vol 82 (7) ◽

pp. 117-129

Author(s):

Gary R. Beasley ◽

Ella J Marsh ◽

William S. Sottile

Keyword(s):

Acute Osteomyelitis ◽

Hemolytic Streptococcus ◽

Beta Hemolytic Streptococcus ◽

Lancefield Group

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Catheter Configuration and Outcome in Patients on Continuous Ambulatory Peritoneal Dialysis: A Prospective Comparison of Two Catheters

Peritoneal Dialysis International ◽

10.1177/089686089401400114 ◽

1994 ◽

Vol 14 (1) ◽

pp. 70-74 ◽

Cited By ~ 60

Author(s):

Björn H. Eklund ◽

Eero O. Honkanen ◽

Aino-Riitta Kala ◽

Lauri E. Kyllönen

Keyword(s):

Peritoneal Dialysis ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Infectious Complications ◽

University Hospital ◽

Exit Site ◽

Catheter Survival ◽

Tenckhoff Catheter ◽

Prospective Comparison ◽

Catheter Tip ◽

The Impact

Objective To examine the impact of peritoneal catheter configuration on mechanical complications, catheter survival, probability of episodes of peritonitis, and probability of exit-site infections associated with the use of catheters for continuous ambulatory peritoneal dialysis (CAPD). Design Prospective randomized trial. Setting CAPD unit in one university hospital. Patients Forty consecutive patients requiring a dialysis catheter for future CAPD were randomized to receive either a single-cuff straight Tenckhoff catheter or a permanently bent single-cuff Swan neck catheter. The skin exit was upward-directed in the Tenckhoff group and downward-directed in the Swan neck group. Results Dialysate leak occurred in one patient and symptomatic catheter tip migration in 3 patients with the Tenckhoff catheter but in none with the single-cuff Swan neckcatheter(p=O.5, p=0.12). No significant differences in catheter survival at 2 years, probability of episodes of peritonitis, or probability of exit-site infections could be demonstrated. Conclusion Catheter configuration did not influence the catheter-related mechanical or infectious complications. We were unable to demonstrate any advantage of the newer, permanently bent single-cuff Swan neck catheter over the conventional straight type.

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