Viridans streptococcus peritonitis in peritoneal dialysis: clinical characteristics and comparison with concurrent polymicrobial infection

Background: Gut microbiota alters in patients with end-stage renal disease, which contributes to inflammation, atherosclerosis, and results in increased incidence of cardiovascular diseases. The present study investigated the potential clinical factors, which influence the gut microbial structure and function in patients undergoing peritoneal dialysis (PD). Methods: This is a cross-sectional study performed in 81 prevalent PD patients. Gut microbiota was assessed by high throughput sequencing of 16S ribosomal ribonucleic acid gene in fecal samples. Gas chromatography was conducted to measure stool short-chain fat acid (SCFA) concentrations. Demographic parameters and clinical characteristics, including dialysis regimen, residual renal function, nutrition, and inflammation, were retrieved and related to the properties of gut microbiota. Results: PD duration, peritoneal glucose exposure, and estimated glomerulus filtration rate (eGFR) were identified to be associated with microbial variations. Significant separation of microbial composition was shown between patients with short or long PD duration ( p = 0.015) and marginal differences were found between patients grouped by different levels of peritoneal glucose exposure ( p = 0.056) or residual renal function ( p = 0.063). A couple of gut bacteria showed different abundance at amplicon sequencing variant level between these patient groups ( p < 0.05). In addition, stool isobutyric and isovaleric acid concentrations were significantly reduced in patients with longer dialysis duration, higher peritoneal glucose exposure, or declined eGFR ( p < 0.05). Conclusions: This pilot study demonstrated that long dialysis duration, high peritoneal glucose exposure, and loss of residual renal function were associated with gut microbiota alteration and reduced branched-chain SCFA production in PD patients.

Download Full-text

Risk factors for peritonitis in patients on continuous ambulatory peritoneal dialysis who undergo colonoscopy: a retrospective multicentre study

BMC Gastroenterology ◽

10.1186/s12876-019-1081-2 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Tae-Geun Gweon ◽

Sung Hoon Jung ◽

Sang Woo Kim ◽

Kang-Moon Lee ◽

Dae Young Cheung ◽

...

Keyword(s):

Risk Factors ◽

Peritoneal Dialysis ◽

Multicentre Study ◽

Endoscopic Mucosal Resection ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Medical Records ◽

Clinical Characteristics ◽

Prophylactic Antibiotics ◽

Randomized Controlled ◽

Mucosal Resection

Abstract Background Colonoscopy is associated with a risk of peritonitis in patients on peritoneal dialysis. However, no study has yet described the risk factors in play. Methods This was a retrospective multicentre study. The medical records of patients on continuous ambulatory peritoneal dialysis (CAPD) who underwent colonoscopy from January 2003 to December 2012 were analysed. We recorded demographic characteristics, colonoscopic factors, use of prophylactic antibiotics, and development of peritonitis. Colonoscopy-related peritonitis was defined as peritonitis developing within 1 week after colonoscopy. Demographic and clinical characteristics were compared between patients who did and those who did not develop peritonitis. Results During the study period, 236 patients on CAPD underwent colonoscopy, of whom 9 (3.8%) developed peritonitis. The rates of polypectomy/endoscopic mucosal resection were significantly higher in the peritonitis group than in the no peritonitis group (66.7 vs. 23.4%, p = 0.009). Prophylactic antibiotics were prescribed before colonoscopy in 65 patients; none developed peritonitis. No patient who developed peritonitis received prophylactic antibiotics (p = 0.067). Conclusions Advanced procedures including polypectomy or endoscopic mucosal resection increase colonoscopy-related peritonitis in patients on CAPD. Randomized controlled trials to investigate whether prophylactic antibiotics are needed to prevent peritonitis in all CAPD patients are warranted.

Download Full-text

Clinical Characteristics and Outcomes of Silent and Non-silent Peritonitis in Patients on Peritoneal Dialysis

Peritoneal Dialysis International ◽

10.3747/pdi.2012.00267 ◽

2013 ◽

Vol 33 (4) ◽

pp. 466-467

Author(s):

S.L.S. Fan ◽

N. Samad

Keyword(s):

Peritoneal Dialysis ◽

Clinical Characteristics

Download Full-text

Clinical Characteristics and Outcome of Relapsing, Recurrent and Repeat Peritonitis in Peritoneal Dialysis Patients

Hong Kong Journal of Nephrology ◽

10.1016/j.hkjn.2015.09.198 ◽

2015 ◽

Vol 17 (2) ◽

pp. S125

Author(s):

Rong Su ◽

Qunying Guo ◽

Xiao Yang ◽

Qian Zhou ◽

Chunyan Yi ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Clinical Characteristics ◽

Dialysis Patients

Download Full-text

Burkholderia CepaciaExit-Site Infection in Peritoneal Dialysis Patients—Clinical Characteristics and Treatment Outcomes

Peritoneal Dialysis International ◽

10.3747/pdi.2015.00122 ◽

2016 ◽

Vol 36 (4) ◽

pp. 390-394 ◽

Cited By ~ 2

Author(s):

Desmond Y.H. Yap ◽

Jasper F.W. Chan ◽

Terence Yip ◽

Maggie M.Y. Mok ◽

Lorraine P.Y. Kwan ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Tract Infection ◽

Medical Treatment ◽

Treatment Outcomes ◽

Burkholderia Cepacia ◽

Clinical Characteristics ◽

Catheter Removal ◽

Site Infection ◽

Intrinsic Resistance ◽

Exit Site Infection

BackgroundBurkholderia cepacia is a hardy bacterium with intrinsic resistance to multiple antibiotics and high transmissibility. Opportunistic healthcare-associated B. cepacia infections among immunocompromised or critically ill patients have been reported, but there is limited data on the clinical characteristics and treatment outcomes of exit-site infection (ESI) in peritoneal dialysis (PD) patients.Patients and methodsPatients who suffered from B. cepacia ESI from 1 January 2004 to 31 December 2014 were reviewed. The clinical characteristics and treatment outcomes of the patients and the antibiotic susceptibility patterns of the bacterial isolates were analyzed.ResultsTwenty-two patients were included for analysis. Eight patients (36.4%) had medical conditions which impaired host immunity, while 7 (31.8%) had pre-existing skin abnormalities. Three patients (13.6%) progressed to tunnel-tract infection and another 3 patients (13.6%) developed associated peritonitis. Fifteen patients (68.2%) responded to medical treatment while 7 (31.8%) required catheter removal. Eleven patients (50.0%) had recurrent B. cepacia ESI, which occurred at 7.8 months (95% confidence interval [CI] 0.1 – 19.4 months) after the first episode. Most B. cepacia strains were susceptible to ceftazidime (95.5%), piperacillin/tazobactam (95.5%), and piperacillin (90.9%). Besides aminoglycosides (80 – 100%), high rates of resistance were also observed for ticarcillin/clavulanate (90.9%).ConclusionBurkholderia cepacia ESI is associated with low rates of tunnel-tract infection or peritonitis, but the risk of recurrence is high. Most cases can be managed with medical treatment alone, although one third of patients might require catheter removal.

Download Full-text

Intracellular ion metabolism in erythrocytes and uraemia: The effect of different dialysis treatments

Clinical Science ◽

10.1042/cs0710545 ◽

1986 ◽

Vol 71 (5) ◽

pp. 545-552 ◽

Cited By ~ 7

Author(s):

Maurizio Trevisani ◽

Natale De Santo ◽

Martin Laurenzi ◽

Michele Di Muro ◽

Franco De Chiara ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Clinical Characteristics ◽

Normal Values ◽

Present Report ◽

Maximal Velocity ◽

Dialysis Treatment ◽

Before And After ◽

Different Response

1. The present report focuses on some aspects of the intra-erythrocytic cation metabolism (e.g. the maximal velocity of the Na+–Li+ countertransport and Na+/K+/Cl−1 cotransport) in uraemic patients on different dialysis treatments. 2. Patients undergoing dialysis treatment [continuous ambulatory peritoneal dialysis (CAPD) or haemodialysis (HD)] overall showed higher Na+–Li+ countertransport than controls. With regard to Na+/K+/Cl−1 cotransport, CAPD patients and controls did not differ and both showed, on average, higher values than HD patients. 3. A subgroup of HD patients was studied before and after dialysis. No significant overall changes were detected as a result of the dialysis process with regard to Na+/K+/Cl−1 cotransport. Na+-Li+ countertransport was significantly reduced by dialysis and a distinctly different response to dialysis was evident according to predialysis values. Patients with high values of Na+–Li+ countertransport showed a significant reduction in this parameter while patients with normal values showed no effect. No distinct association was detected between alteration in either Na+–Li+ countertransport or Na+/K+/Cl−1 cotransport and the clinical characteristics of the patients. 4. It is concluded that uraemia and/or dialysis influences the maximal velocity of the parameters under investigation. The effect on Na+–Li+ countertransport seems to be similar for both CAPD and HD, while Na+/K+/Cl−1 cotransport is not altered in CAPD patients.

Download Full-text

Risk factors for peritonitis in patients on continuous ambulatory peritoneal dialysis who undergo colonoscopy: A retrospective multicentre study

10.21203/rs.2.11212/v1 ◽

2019 ◽

Author(s):

Tae-Geun Gweon ◽

Sung Hoon Jung ◽

Sang Woo Kim ◽

Kang-Moon Lee ◽

Dae Young Cheung ◽

...

Keyword(s):

Risk Factors ◽

Peritoneal Dialysis ◽

Multicentre Study ◽

Endoscopic Mucosal Resection ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Medical Records ◽

Clinical Characteristics ◽

Demographic Characteristics ◽

Prophylactic Antibiotics ◽

Mucosal Resection

Abstract Background: Colonoscopy is associated with a risk of peritonitis in patients on peritoneal dialysis. However, no study has yet described the risk factors in play. Methods: This was a retrospective multicentre study. The medical records of patients on continuous ambulatory peritoneal dialysis (CAPD) who underwent colonoscopy from January 2003 to December 2012 were analysed. We recorded demographic characteristics, colonoscopic factors, use of prophylactic antibiotics, and development of peritonitis. Colonoscopy-related peritonitis was defined as peritonitis developing within 1 week after colonoscopy. Demographic and clinical characteristics were compared between patients who did and those who did not develop peritonitis. Results: During the study period, 236 patients on CAPD underwent colonoscopy, of whom 9 (3.8%) developed peritonitis. The rates of polypectomy/endoscopic mucosal resection were significantly higher in the peritonitis group than in the no peritonitis group (66.7 vs. 23.4%, p=0.009). Prophylactic antibiotics were prescribed before colonoscopy in 65 patients; none developed peritonitis. No patient who developed peritonitis received prophylactic antibiotics (p=0.067). Conclusions: Advanced procedures including polypectomy or endoscopic mucosal resection increase colonoscopy-related peritonitis in patients on CAPD. Prophylactic antibiotics should be administered before colonoscopy to such patients.

Download Full-text