scholarly journals Evaluation of T2Candida Panel for detection of Candida in peritoneal dialysates

2020 ◽  
Vol 40 (1) ◽  
pp. 96-99
Author(s):  
Anne M Kouri ◽  
Theodore W Kieffer ◽  
Corina Nailescu ◽  
Jeffrey Leiser ◽  
Bryan H Schmitt ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
New Technology ◽  
Unmet Need ◽  
Cross Reactivity ◽  
Rapid Diagnostics ◽  
Candida Spp ◽  
Full Spectrum ◽  
Fungal Peritonitis ◽  
Peritoneal Dialysate ◽  
Patient Specimen

Fungal peritonitis in the peritoneal dialysis population is difficult to diagnose promptly due to the inherently slow cultivation-based methods currently required for identification of peritonitis pathogens. Because of the moderate risk for severe complications, the need for rapid diagnostics is considerable. One possible solution to this unmet need is the T2Candida Panel, a new technology designed to detect the most common pathogenic Candida spp. directly from whole blood specimens in as little as a few hours. We hypothesized that this technology could be applied to the detection of Candida in peritoneal dialysate, a matrix not currently approved by the Food and Drug Administration for testing by this system. Remnant dialysate samples from three healthy (noninfected) pediatric peritoneal dialysis patients were spiked with Candida glabrata, serially diluted, and tested in triplicate with unaltered dialysate specimens. The assay detected C. glabrata in 100% of spiked dialysate samples across the full spectrum of dilutions tested, and no assay inhibition or cross-reactivity was noted. These findings suggest one of possibly more applications of this technology. The positive clinical implications of this test will continue to be realized as its use is validated in peritoneal dialysate and other patient specimen types.

Iron Chelation Therapy in CAPD: A New and Effective Treatment of Iron Overload Disease in Esrd Patients

1983 ◽  
Vol 3 (2) ◽  
pp. 99-101 ◽  
Author(s):  
Glen H Stanbaugh ◽  
A. W, Holmes Diane Gillit ◽  
George W. Reichel ◽  
Mark Stranz
Keyword(s):  
Peritoneal Dialysis ◽  
Iron Overload ◽  
End Stage Renal Disease ◽  
Chelation Therapy ◽  
Iron Chelation ◽  
Iron Chelation Therapy ◽  
Peritoneal Dialysate ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

A patient with end-stage renal disease on CAPD, and with massive iron overload is reported. This patient had evidence of myocardial and hepatic damage probably as a result of iron overload. Treatment with desferoxamine resulted in removal of iron in the peritoneal dialysate. On the basis of preliminary studies in this patient it would appear that removal of iron by peritoneal dialysis in conjunction with chelation therapy is safe and effective. This finding should have wide-ranging signficance for patients with ESRD.

scholarly journals THE RISK FACTORS AND OUTCOME OF FUNGAL PERITONITIS IN CONTINUOUS AMBULATORY PERITONEAL DIALYSIS PATIENTS

2009 ◽  
Vol 27 (1) ◽  
pp. 59-61
Author(s):  
E Indhumathi ◽  
V Chandrasekaran ◽  
D Jagadeswaran ◽  
M Varadarajan ◽  
G Abraham ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Dialysis Patients ◽  
Fungal Peritonitis

scholarly journals Cefoperazone and sulbactam-related eosinophilic peritonitis: a case report and literature review

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110253
Author(s):  
Zi Wang ◽  
Zhiying Li ◽  
Suping Luo ◽  
Zhikai Yang ◽  
Ying Xing ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Blood Cells ◽  
White Blood Cells ◽  
Antibiotic Use ◽  
Absolute Count ◽  
Peritoneal Dialysate ◽  
Refractory Peritonitis ◽  
Technique Failure ◽  
Peritoneal Dialysis Effluent ◽  
Pathogenic Infection

Eosinophilic peritonitis (EP) is a well-described complication of peritoneal dialysis that occurs because of an overreaction to constituents that are related to the catheter or tubing, peritoneal dialysate, pathogenic infection, or intraperitoneal drug use. EP caused by antibiotic use is rare. We present the case of a patient with cefoperazone and sulbactam-related EP. A 59-year-old woman who was undergoing peritoneal dialysis presented with peritonitis with abdominal pain and turbid peritoneal dialysis. Empiric intraperitoneal cefazolin in combination with cefoperazone and sulbactam was started after peritoneal dialysis effluent cultures were performed. Her peritonitis achieved remission in 2 days with the help of cephalosporin, but she developed EP 1 week later, when her dialysate eosinophil count peaked at 49% of the total dialysate white blood cells (absolute count, 110/mm3). We excluded other possible causes and speculated that cefoperazone and sulbactam was the probable cause of EP. The patient continued treatment with cefoperazone and sulbactam for 14 days. EP resolved within 48 hours after stopping cefoperazone and sulbactam. Thus, EP can be caused by cefoperazone and sulbactam use. Physicians should be able to distinguish antibiotic-related EP from refractory peritonitis to avoid technique failure.

scholarly journals Penetration of Isavuconazole in Ascites Fluid of Critically Ill Patients

2021 ◽  
Vol 7 (5) ◽  
pp. 376
Author(s):  
Tobias Lahmer ◽  
Gonzalo Batres Baires ◽  
Roland M. Schmid ◽  
Johannes R. Wiessner ◽  
Jörg Ulrich ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Ascites Fluid ◽  
Candida Spp ◽  
Fungal Peritonitis ◽  
Penetration Ratio ◽  
Threatening Condition ◽  
Liquid Chromatography Tandem Mass ◽  
Life Threatening ◽  
Fluid Levels

Fungal peritonitis is a life-threatening condition which is not only difficult to diagnose, but also to treat. Following recent guidelines, echinocandins and azoles are the recommended antimycotics for the management of intra-abdominal Candida spp. infections, with a favor for echinocandins in critically ill patients. However, the new extended spectrum triazole isavuconazole also has a broad spectrum against Candida spp. Data on its target-site penetration are sparse. Therefore, we assessed isavuconazole concentrations and penetration ratios in ascites fluid of critically ill patients. Obtaining of Isavuconazole plasma and ascites fluid levels as well penetration ratios using paracentesis in critically ill patients. Isavuconazole concentrations were quantified in human plasma and ascites by a liquid chromatography/tandem mass spectrometry (LC-MS/MS) method. Isavuconazole concentrations in plasma and ascites fluid were measured in sixteen critically ill patients. Isavuconazol levels in ascites fluid (1.06 µg/mL) were lower than plasma levels (3.08 µg/mL). Penetration ratio was 36%. In two out of sixteen patients, Candida spp., in detail C. glabrata and C. tropicalis, could be isolated. Cmax/MIC Ratio in plasma of 560 for C. glabrata and 2166 for C. tropicalis could be observed. Following our results, isavuconazole penetrates into ascites. Successful treatment in Candida spp. peritonitis depends on pathogen susceptibility.

The Iron Biology Status of Peritoneal Dialysis Patients May be a Risk Factor for Development of Infectious Peritonitis

2019 ◽  
Vol 39 (4) ◽  
pp. 362-374 ◽  
Author(s):  
Marwh Aldriwesh ◽  
Noura Al-Dayan ◽  
Jonathan Barratt ◽  
Primrose Freestone
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Stress Hormones ◽  
Infection Risk ◽  
Mortality And Morbidity ◽  
Peritoneal Dialysate ◽  
Susceptibility To Infection ◽  
Infection Risk Factors

Background Infectious peritonitis is a clinically important condition contributing to the significant mortality and morbidity rates observed in peritoneal dialysis (PD) patients. Although some of the socioeconomic risk factors for PD-associated peritonitis have been identified, it is still unclear why certain patients are more susceptible than others to infection. Methods We examined the molecular components of human peritoneal dialysate (HPD) in an attempt to identify factors that might increase patient susceptibility to infection. Characterization studies were performed on initial and follow-up dialysate samples collected from 9 renal failure patients on PD. Results Our in vitro data showed that peritonitis-causing bacteria grew differently in the patient dialysates. Proteomic analysis identified an association between transferrin presence and infection risk, as peritoneal transferrin was discovered to be iron-saturated, which was in marked contrast to transferrin in blood. Further, use of radioactive iron-labeled transferrin showed peritoneal transferrin could act as a direct iron source for the growth of peritonitis-causing bacteria. We also found catecholamine stress hormones noradrenaline and adrenaline were present in the dialysates and were apparently involved in enhancing the growth of the bacteria via transferrin iron provision. This suggests the iron biology status of the PD patient may be a risk factor for development of infectious peritonitis Conclusions Collectively, our study suggests transferrin and catecholamines within peritoneal dialysate may be indicators of the potential for bacterial growth in HPD and, as infection risk factors, represent possible future targets for therapeutic manipulation.

Peritoneal dialysis related fungal peritonitis caused byCandida krusei: The first reported case

Nephrology ◽  
2018 ◽  
Vol 23 (7) ◽  
pp. 703-704
Author(s):  
Ren Tong ◽  
Shouci Hu ◽  
Hongtao Yang
Keyword(s):  
Peritoneal Dialysis ◽  
Fungal Peritonitis

Rectal Stenosis Associated with Fungal Peritonitis: A Complication of Continuous Ambulatory Peritoneal Dialysis

Nephron ◽  
1989 ◽  
Vol 53 (3) ◽  
pp. 288-289 ◽  
Author(s):  
Masako Uchida ◽  
Takanobu Sakemi ◽  
Yoshiro Nagano ◽  
Masanobu Mizuguchi
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Rectal Stenosis ◽  
Fungal Peritonitis

Exserohilum Peritonitis in Peritoneal Dialysis in Northern China: A Case Report

2019 ◽  
Vol 39 (2) ◽  
pp. 175-176
Author(s):  
Yan Liu ◽  
Wenjing Gong ◽  
Yanming Yu ◽  
Lihua Jiang
Keyword(s):  
Peritoneal Dialysis ◽  
Case Report ◽  
Candida Species ◽  
Rare Case ◽  
Northern China ◽  
Catheter Removal ◽  
Fungal Peritonitis ◽  
Anti Fungal

Fungal peritonitis is a catastrophic complication of peritoneal dialysis (PD) and often requires termination of PD. It is usually caused by Candida species. Here we report a rare case of Exserohilum peritonitis. The patient was successfully treated with catheter removal and anti-fungal therapy.

scholarly journals Management of fungal peritonitis : a Moroccan single peritoneal dialysis unit experience

2019 ◽  
Vol 2 (2) ◽  
pp. 65-69
Author(s):  
Moussokoro Hadja Kone ◽  
Tarik Bouattar ◽  
Ibtissam Fares ◽  
Meryem Benbella ◽  
Naima Ouzeddoun ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Death Rate ◽  
Clinical Signs ◽  
Dropping Out ◽  
Average Delay ◽  
Dialysis Unit ◽  
Fungal Peritonitis ◽  
Individual Care ◽  
Serious Infection ◽  
Encapsulating Peritonitis

Introduction: Fungal peritonitis (PF) in peritoneal dialysis (PD) is a serious infection that involves the functional prognosis of the peritoneum and the patient's vital prognosis. It must benefit from a fast handling but nevertheless not very codified. Each center therefore ensures an individual care of its patients. Materiel and method: The purpose of our study is to describe our 10-year experience through our patients who presented FP. We performed a descriptive retrospective study of FP cases documented in the PD unit. Results: the prevalence of FP was 5,1%, which represent 9 cases. Predominant clinical signs were dialysat turbidity and abdominal pain. FP was primitive for 3 patients. The antifungal therapy used was Fluconazole, which was combined with an increased number of peritoneal exchanges. DP catheter ablation was done for 8 patients with an average delay of 5.5 days. The overall outcome was favorable and 3 patients continued PD. No death or encapsulating peritonitis was a consequence of FP. Discussion and conclusion: FP is an infectious complication in PD. Its’ death rate is elevated; dropping-out of PD rate too is elevated. The favorable evolution of our patients that stayed in PD let us think that it may be possible to maintain more patients in PD after FP.

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