Relapsing Peritonitis in Continuous Ambulatory Peritoneal Dialysis (CAPD): Treatment by Interruption of CAPO and Prolonged Antibiotic Therapy

1988 ◽  
Vol 8 (2) ◽  
pp. 155-157 ◽  
Author(s):  
K. Shashi Kant ◽  
Daniel Goetz ◽  
Cynthia Marzluff ◽  
Denise Motz
Keyword(s):  
Peritoneal Dialysis ◽  
Antibiotic Therapy ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Systemic Treatment ◽  
Peritoneal Catheter ◽  
New Approach ◽  
Bacterial Peritonitis ◽  
Dialysis Facility ◽  
Systemic Antibiotics ◽  
Prolonged Antibiotic Therapy

Relapsing peritonitis was assessed in the continuous ambulatory peritoneal dialysis (CAPD) population of a large, outpatient dialysis facility. Prolonged systemic treatment with antibiotics often fails, resulting in the eventual removal and subsequent reimplantation of the catheter. We have tried a new approach to avoid removal of the peritoneal catheter. Patients were treated by the interruption of CAPD, conversion to hemodialysis or discontinuation of dialysis for a period of 7 to 21 days while continuing systemic antibiotics. Over a period of 76.63 patient years, 69 episodes of bacterial peritonitis occurred (0.9 episodes per patient year). Of these, five episodes could be classified as relapsing peritonitis. Five patients with gram-positive relapsing peritonitis were treated by this regimen; all responded with a cure. Our results suggest that relapsing peritonitis can be eradicated without the removal of the peritoneal catheter.

scholarly journals A case of bacterial peritonitis caused by Roseomonas mucosa in a patient undergoing continuous ambulatory peritoneal dialysis

2013 ◽  
Vol 3 (2) ◽  
pp. 127-131 ◽  
Author(s):  
Yuta Matsukuma ◽  
Koji Sugawara ◽  
Shota Shimano ◽  
Shunsuke Yamada ◽  
Kazuhiko Tsuruya ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Bacterial Peritonitis ◽  
Roseomonas Mucosa

A Randomized Prospective Comparison of Oral versus Intraperitoneal Ciprofloxacin as the Primary Treatment of Peritonitis Complicating Continuous Ambulatory Peritoneal Dialysis

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 351-354 ◽  
Author(s):  
I.K.P. Cheng ◽  
C.Y. Chan ◽  
W.T. Wong ◽  
S.W. Cheng ◽  
C.W. Ritchie ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Treatment Group ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Bacterial Resistance ◽  
Oral Treatment ◽  
Prospective Trial ◽  
Primary Treatment ◽  
Drug Levels ◽  
Bacterial Peritonitis ◽  
Prospective Comparison

The present study compared oral versus Intraperitoneal (ip) ciprofioxacin (ciproxin) as primary treatment of bacterial peritonitis in patients receiving continuous ambulatory peritoneal dialysis (CAPD) In a randomized, prospective trial. A total of 54 episodes In 46 patients were recruited for study. After excluding nonbacterial episodes and those not treated according to protocol, 48 episodes evenly divided between the two treatment arms were eligible for analysis. The primary cure rate was 41.7% and 66.7%, respectively, In the oral and Ip treatment group. Half of those who tailed or relapsed were due to Infection with resistant, mostly grampositive bacteria, which accounted for 79% of culture-positive episodes. Of the gram-positive Isolates 42.3% were either resistant or Intermediately susceptible to ciproxin compared to 16.7% of gram-negative Isolates. The high level of bacterial resistance to ciproxin and treatment failure rate were related to the previous exposure to fluoroquinolones. Inadequate trough peritoneal drug levels also accounted for the failures in the Ip but not the oral treatment group. We conclude that oral ciproxin is ineffective as a primary treatment of CAPD peritonitis in patients previously exposed to fluoroquinolones and that when administered Ip, a dose of 50 mg/L Instead of 25 mg/L of ciproxin should be used as maintenance In order to achieve adequate trough peritoneal drug levels.

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

2015 ◽  
Vol 40 (1) ◽  
pp. 72-78 ◽  
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.

scholarly journals Listeria monocytogenes Peritonitis in a Patient Receiving Continuous Ambulatory Peritoneal Dialysis: A Case Report and Review of the Literature

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Ho-Kwan Sin ◽  
Au Cheuk ◽  
William Lee ◽  
Ka-Fai Yim ◽  
Clara Poon ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Case Report ◽  
Listeria Monocytogenes ◽  
Antibiotic Therapy ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Optimal Management ◽  
Review Of The Literature

Listeria monocytogenes is a rare cause of peritoneal dialysis-related peritonitis. Only a handful of cases have been reported, and the optimal management is still uncertain. We present a case of Listeria monocytogenes peritonitis and perform a review of the literature to elucidate optimal antibiotic therapy.

Peritonitis-Related Deaths in Continuous Ambulatory Peritoneal Dialysis (CAPD) Patients

1990 ◽  
Vol 10 (1) ◽  
pp. 45-47 ◽  
Author(s):  
George E. Digenis ◽  
Georgi Abraham ◽  
Eugene Savin ◽  
Peter Blake ◽  
Nicholas Dombros ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Serum Proteins ◽  
Total Serum ◽  
Contributing Factors ◽  
Peritoneal Catheter ◽  
Staph Aureus ◽  
Artery Disease ◽  
Present On Admission

A total of 636 episodes of peritonitis occurred in 440 patients who entered our continuous ambulatory peritoneal dialysis (CAPD) program from September 1977 to February 1988. Sixteen patients (8 male and 8 female, aged 37–77 years) died during an episode of peritonitis (fatality rate 2.5%). They had been on CAPD for 3 to 105 (average 39) months. Six of them were diabetics. The peritonitis rate among these 16 patients were 1 episode per 12 patient months, while the corresponding figure for the whole (440) CAPD population was 14 patient months. Risk factors present in the 16 patients were: cardiovascular disease (12), cerebrovascular accident (2) peripheral artery disease (1) and pulmonary fibrosis (1). Fever and leukocytosis were present on admission in 11 patients, while total serum proteins and albumin were significantly lower (p < 0.001) than the corresponding values before peritonitis (56 ± 8 vs. 65 ± 5). Staph. aureus was isolated in 8 patients (50%), multiple organisms in 6, Pseudomonas and Candida albicans in 1 each. An abdominal abscess was found in 4 (25%) patients. The peritoneal catheter was removed between the 5th and 10th day in 6 and after the 10th day in 7 patients. Peritonitis with sepsis was the cause of death in 13 patients. Contributing factors were cardiovascular accident in 9, uremic coma in 2, extensive GI bleeding in 2, GI performation in 2, intestinal infarction in 1, and pneumonia in 2 patients. We conclude that the risk of peritonitis-related death in CAPD patients is increased with Staph. aureus or multibacterial peritonitis. Contributing factors are concomitant cardiovascular disease and delayed (>5 days) catheter removal.

An Unusual Cause of Massive Intraperitoneal Bleeding in CAPD

1984 ◽  
Vol 4 (4) ◽  
pp. 257-258 ◽  
Author(s):  
Joseph Shohat Zaki ◽  
Shapira Alexander Yussim ◽  
Geoffrey Boner
Keyword(s):  
Peritoneal Dialysis ◽  
Blood Vessels ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Rare Complication ◽  
Fibrous Tissue ◽  
Massive Bleeding ◽  
Peritoneal Catheter ◽  
Intraperitoneal Hemorrhage ◽  
Intraperitoneal Bleeding ◽  
Capd Patient

A 73-year-old man, who had been on CAPD for two years, presented with massive intraperitoneal hemorrhage. On laparotomy the peritoneal catheter was situated in a large pouch that was lined by fibrous tissue. The hemorrhage arose from erosion of the pouch wall -an unusual cause of intraperitoneal bleeding in the CAPD patient. Massive intraperitoneal bleeding is a rare complication of continuous ambulatory peritoneal dialysis (CAPD). Mild to moderate bleeding, which is more common in CAPD, usually is related to disintegration of small blood vessels. In most patients the bleeding is self-limited. This paper describes an unusual cause of massive bleeding in a CAPD patient.

Single Daily Dose of Aminoglycosides in the Treatment of Continuous Ambulatory Peritoneal Dialysis Peritonitis

1993 ◽  
Vol 13 (2_suppl) ◽  
pp. 355-356 ◽  
Author(s):  
Stephen I. Vas
Keyword(s):  
Peritoneal Dialysis ◽  
Antibiotic Therapy ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Single Daily Dose ◽  
Blood Levels ◽  
Intermittent Therapy ◽  
Postantibiotic Effect ◽  
Daily Dose

Toxicity of amlnoglycosides is a major concern in the treatment of continuous ambulatory peritoneal dialysis (CAPO) peritonitis. The relatively high blood levels and prolonged and repeated usage may all be contributory. The recognition of the so-called postantibiotic effect, together with the Increased phagocytosis of antiblotictreated cells, may introduce a new mode of therapy with once-dally dosage. Intermittent therapy with vancomycin Is already generally accepted. The extension of this modality to antibiotic therapy is discussed.

Massive Colonization ofan In-Dwelling Catheter by Penicillium Pinophilum without Peritonitis

1984 ◽  
Vol 4 (4) ◽  
pp. 243-244 ◽  
Author(s):  
Romano Locci ◽  
Romagnoni Marcello ◽  
Marcello Beccari ◽  
Sergio Faiolo ◽  
Elisabetta Granello ◽  
...  
Keyword(s):  
Poor Prognosis ◽  
Clinical Symptoms ◽  
Peritoneal Catheter ◽  
Similar Sequence ◽  
Bacterial Peritonitis ◽  
Primary Peritonitis ◽  
Penicillium Pinophilum ◽  
Prolonged Antibiotic Therapy ◽  
In Situ Examination

This paper describes invasion of an indwelling peritoneal catheter by a fungus. This colonization by Penicillium pinophilum, whose identity was proved by isolation, mycological characterization and in situ examination by scanning electron microscopy, did not cause peritonitis. We have discussed possible causes of contamination and implications of the findings. Fungi rarely are responsible for primary peritonitis in CAPD patients, though increasingly they are recognized as secondary agents (1). Mycetes so far isolated belong to the following genera: Aspergillus, Candida. Drechslera, Fusarium, Mucar, Rhodotorula and Trichosparan (2–10). Recently Pearson et al (II) described Penicillium peritonitis which appeared to have been induced by prolonged antibiotic therapy, following repeated episodes of bacterial peritonitis. A similar sequence was encountered after intestinal perforation (3). In CAPD patients peritonitis caused by fungi does not differ from the more common bacterial peritonitis (3), though at first the clinical symptoms may be attenuated and effluent solution may be clear (6, 11). In some cases however such peritonitis can be particularly severe and persistent (12). In these circumstances the catheter should ∼ removed (2, 13, 14), because then the infection clears without specific antifungal therapy. Colonization of the in -dwelling device is associated with a poor prognosis (15). This report describes a patient with massive colonization of the exposed tract of the Tenckhoff peritoneal catheter with Penicillium without clinical symptoms of peritonitis or changes in the dialysate effluent.

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