scholarly journals First Report ofLaribacter hongkongensisPeritonitis in Continuous Ambulatory Peritoneal Dialysis

2016 ◽  
Vol 36 (1) ◽  
pp. 105-107 ◽  
Author(s):  
Patrick C.Y. Woo ◽  
Rosana W.S. Poon ◽  
Chuen-Hing Foo ◽  
Kelvin K.W. To ◽  
Susanna K.P. Lau
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Clinical Condition ◽  
Bacterial Identification ◽  
Gram Positive ◽  
First Report ◽  
Gram Positive Bacteria ◽  
First Case ◽  
Laribacter Hongkongensis

The most common pathogens associated with peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD) are gram-positive bacteria, which constitute 60 – 80% of all isolates.With the advancement of molecular technologies for bacterial identification, cases of CAPD-related peritonitis caused by bacteria previously not known to be associated with this clinical condition have been reported. Here we report the first case of CAPD-related peritonitis due to Laribacter hongkongensis.

Ciprofloxacin in the Treatment of Gram-Positive Bacterial Peritonitis in Patients Undergoing CAPD

1991 ◽  
Vol 11 (3) ◽  
pp. 233-236 ◽  
Author(s):  
Miguel Pérez-Fontán ◽  
Miguel Rosales ◽  
Fernando Fernández ◽  
Javier Moncalián ◽  
Constatino Fernández-Rivera ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Peritoneal Dialysis ◽  
Side Effects ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Good Alternative ◽  
Drug Side Effects ◽  
Gram Positive ◽  
Therapeutic Alternative ◽  
Bacterial Peritonitis ◽  
Gram Positive Bacteria

Fluoroquinolones may be a good alternative for the treatment of bacterial peritonitis in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). To test their efficiency against Gram-positive bacteria, we treatedwith intraperitoneal (i.p.) ciprofloxac in 30 episodes of Gram-positive bacterial peritonitis without manifest tunnel infection of the peritoneal catheters. Treatment was sustained for 5 days, then orally for 10 further days. Clinical and bacteriological responses were satisfactory in 25 cases, but resolution of infection was slow in 5 cases of Staphylococcus aureus. The minimal inhibitory and bactericidal concentrations were 0.06250.50 and 0.125-1.0 μg/mL respectively, lower than the plasma and dialysate concentrations of the drug. Side effects were negligible. We conclude that ciprofloxacin provides a good therapeutic alternative to more widely used antibiotics for the empirical treatment of peritonitis in patients undergoing CAPD. However, combinations of antibiotics may be necessary, in Staphylococcus aureus peritonitis.

Peritonitis Caused by Monilia sitophila in a Patient Undergoing Peritoneal Dialysis

1996 ◽  
Vol 19 (4) ◽  
pp. 218-220 ◽  
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.

The Impact of Peritonitis on Peritoneal and Systemic Acid-Base Status of Patients on Continuous Ambulatory Peritoneal Dialysis

1994 ◽  
Vol 14 (1) ◽  
pp. 61-65 ◽  
Author(s):  
Jacques J. Sennesael ◽  
Godelieve C. De Smedt ◽  
Patricia Van der Niepen ◽  
Dierik L. Verbeelen
Keyword(s):  
Staphylococcus Aureus ◽  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Acid Base ◽  
Gram Positive ◽  
Gram Negative ◽  
Arterial Blood ◽  
Blood Ph ◽  
Acid Base Status ◽  
And Staphylococcus Aureus

Objective To assess the possible effects of peritonitis on peritoneal and systemic acid-base status. Design pH, pCO2, lactate, and total leukocyte and differential count were simultaneously determined in the overnight dwell peritoneal dialysis effluent (PDE) and arterial blood in noninfected patients (controls) and on days 1, 3, and 5 from the onset of peritonitis. Setting University multidisciplinary dialysis program. Patients Prospective analysis of 63 peritonitis episodes occurring in 30 adult CAPD patients in a single center. Results In controls, mean (±SD) acid-base parameters were pH 7.41 ±0.05, pCO2 43.5±2.6 mm Hg, lactate 2.5±1.5 mmol/L in the PDE, and pH 7.43±0.04, PaCO2 36.8±3.8 mm Hg, lactate 1.4±0.7 mmol/L in the blood. In sterile (n=6), gram-positive (n=34), and Staphylococcus aureus (n=9) peritonitis PDE pH's on day 1 were, respectively, 7. 29±0.07, 7. 32±0.07, and 7.30±0.08 (p<0.05 vs control). In gram -negative peritonitis (n=14) PDE pH was 7.21 ±0.08 (p<0.05 vs all other groups). A two-to-threefold increase in PDE lactate was observed in all peritonitis groups, but a rise in pCO2 was only seen in gram -negative peritonitis. Acid-base profile of PDE had returned to control values by day 3 in sterile, gram -positive and Staphylococcus aureus peritonitis and by day 5 in gramnegative peritonitis. Despite a slight increase in plasma lactate on the first day of peritonitis, arterial blood pH was not affected by peritonitis. Conclusion PDE pH is decreased in continuous ambulatory peritoneal dialysis (CAPD) peritonitis, even in the absence of bacterial growth. In gram-negative peritonitis, PDE acidosis is more pronounced and prolonged, and pCO2 is markedly increased. Arterial blood pH is not affected by peritonitis.

Outcome of Gram-Positive and Gram-Negative Peritonitis in Patients on Continuous Ambulatory Peritoneal Dialysis: A Single-Center Experience

2003 ◽  
Vol 23 (2_suppl) ◽  
pp. 144-147 ◽  
Author(s):  
Narayan Prasad ◽  
Amit Gupta ◽  
Raj K. Sharma ◽  
Kashi N. Prasad ◽  
Sanjeev Gulati ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Total Duration ◽  
Educational Status ◽  
Developed Countries ◽  
Outcome Analysis ◽  
Gram Positive ◽  
Fungal Peritonitis ◽  
Gram Negative ◽  
Single Center Experience

Background The spectrum of bacterial peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPD) in India may be different from that seen in developed countries because of differences in culture and in social, environmental, financial, and educational status. We analyzed our data regarding the incidence and outcome of monomicrobial peritonitis in our CAPD patients. Patients and Methods We reviewed the records of 225 patients on CAPD to retrieve data concerning demographics, peritonitis rate, organism isolated, and outcome. Polymicrobial and fungal peritonitis were excluded from the outcome analysis because of their different outcomes. Results We identified 168 episodes of peritonitis (range: 1 – 6 episodes per patient). Of the 168 episodes, 106 (63.1%) episodes were culture-positive. Total duration of CAPD was 264.16 patient–years. The overall peritonitis rate was 0.63 episodes per patient–CAPD year. The rates of gram-negative, gram-positive, polymicrobial, and fungal peritonitis were 0.17, 0.11, 0.04, 0.09 episodes per patient–year, respectively. Among the 75 episodes of monomicrobial peritonitis, gram-negative episodes [ n = 45 (60%)] were significantly more frequent than gram-positive episodes [ n = 30 (40%), p = 0.03]. Escherichia coli was the most commonly seen organism. Organisms of fecal origin (40/75) were significantly more frequent than those of skin origin (21/75, p = 0.0016). Catheter loss (17/45 vs 5/20, p = 0.04), hospitalization (31/ 45 vs 13/30, p = 0.03), death [9/45 vs 3/30, p = nonsignificant (NS)], switch to hemodialysis (8.9% vs 3.3%, p = NS), and reimplantation of the catheter (6.6% vs 3.3%, p = NS) were all more frequent in gram-negative episodes than in gram-positive episodes. Conclusions Gram-negative peritonitis is more frequent than gram-positive peritonitis in our CAPD population in India and is associated with worse outcome.

Factors Affecting Ul Trafil Tration in Continuous Ambulatory Peritoneal Dialysis First Report of an International Cooperative Study

1984 ◽  
Vol 4 (1) ◽  
pp. 14-19 ◽  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Cooperative Study ◽  
Mean Values ◽  
Factors Affecting ◽  
First Report ◽  
The Usa ◽  
Chronic Use

In 20 participating centers in Canada, France and the USA, 210 patients on continuous ambulatory peritoneal dialysis for one to 66 months underwent drainage measurements with a hypertonic (3.86 to 4.5 gm % dextrose), 2L, four-hour-dwell exchange. Patients had used lactate solutions only (n = 73), acetate solutions only (n = 21), or acetate before a change to lactate (n = 16). Mean net ultrafiltration (± SEM) (UF, ml) values were 701 ± 22, 489 ± 61, and 390 ± 56 respectively; mean dialysate glucose concentrations (mg/dl) were 1053 ± 23, 722 ± 107, and 701 ± 24. Mean values in groups exposed to acetate were significantly (p < 0.01) below those in the lactate-only group. There was no significant correlation of UF with the peritonitis rate; in the lactate-only group, there was no significant correlation between UF and time on CAPD. In summary, the chronic use of acetate solutions appeared to be associated with more rapid decreases in dialysate glucose and low UF Slingeneyer et al reported that 10 and 30% of patients treated with continuous ambulatory peritoneal dialysis (CAPD) at their center in France lose ultrafiltration capacity at one and two years respectively (I). Eventually 24% of patients with decreasing ultrafiltration had to be transferred to hemodialysis.

Case 23

2020 ◽  
pp. 151-157
Author(s):  
Hilary Humphreys
Keyword(s):  
Peritoneal Dialysis ◽  
Recurrent Infection ◽  
Positive Culture ◽  
Personal Hygiene ◽  
Peritoneal Dialysis Catheter ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Fungal Peritonitis ◽  
Gram Positive Bacteria ◽  
Culture Negative

Infection is one of the commonest complications of continuous ambulatory peritoneal dialysis (CAPD) which often presents with a cloudy bag and sometimes abdominal pain. Gram-positive bacteria, such as coagulase negative staphylococci, are the commonest cause. The diagnosis is confirmed by markedly elevated white cells in the CAPD fluid and a positive culture. Empiric antibiotics should cover Gram-positive and Gram-negative bacteria—e.g intra-peritoneal vancomycin and gentamicin—which are modified when culture and antibiotic susceptibility results are available. Removal of the peritoneal dialysis catheter is indicated in pseudomonal and fungal peritonitis and when there is recurrent infection. Culture-negative CAPD infection may be due to tuberculosis. Minimizing infection is largely achieved through good standards of personal hygiene, patient training and education, and home visits.

Acute Peritonitis Caused by Staphylococcus capitis in a Peritoneal Dialysis Patient

2017 ◽  
Vol 37 (1) ◽  
pp. 115-116 ◽  
Author(s):  
Nikolina Basic-Jukic
Keyword(s):  
Peritoneal Dialysis ◽  
Dialysis Patient ◽  
Peritoneal Dialysis Patient ◽  
Bacterial Identification ◽  
Common Complication ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Acute Peritonitis ◽  
Staphylococcus Capitis

Acute peritonitis remains the most common complication of peritoneal dialysis (PD), with coagulase-negative staphylococci (CoNS) reported to account for more than 25% of peritonitis episodes ( 1 ). Staphylococcus capitis is a gram-positive, catalase-positive CoNS that was originally identified as a commensal on the skin of the human scalp ( 2 ). Advancement of microbiological technologies for bacterial identification enables diagnosis of previously unknown causes of acute peritonitis. This is the first reported case of acute peritonitis in a PD patient caused by S. capitis.

Prophylaxis against Gram-Positive Organisms Causing Exit-Site Infection and Peritonitis in Continuous Ambulatory Peritoneal Dialysis Patients by Applying Mupirocin Ointment at the Catheter Exit Site

2003 ◽  
Vol 23 (2_suppl) ◽  
pp. 153-158 ◽  
Author(s):  
Sunny S.H. Wong ◽  
Kwok Hong Chu ◽  
Au Cheuk ◽  
Wai Kay Tsang ◽  
Samuel K.S. Fung ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Local Application ◽  
Diabetic Patients ◽  
Site Infection ◽  
Dialysis Patients ◽  
Exit Site ◽  
Gram Positive ◽  
Exit Site Infection ◽  
Mupirocin Ointment

Objective We evaluated the effectiveness of local application of mupirocin ointment at the catheter exit site in preventing exit-site infection and peritonitis attributable to gram-positive organisms in continuous ambulatory peritoneal dialysis patients. Methods This prospective randomized controlled trial included 154 patients. They were randomly allocated to a mupirocin-treated group (group M) and a control group (group C). Group M included 73 patients (47.4%) who were instructed to apply mupirocin ointment to the catheter exit site once daily after the routine daily exit-site dressing. Group C included 81 patients (52.6%) who continued their usual daily exit-site care without applying mupirocin. The two groups were followed to see whether there would be any difference in the frequency of exit-site infection and peritonitis or in the infecting organisms. Results Interim data were collected at 5 months after the start of the study. Those data showed a significantly lower incidence of exit-site infection and peritonitis attributable to gram-positive organisms in group M as compared with group C. The incidence of gram-positive exit-site infection in group C was 1 episode per 36.8 patient–months; in group M, the incidence was 1 episode per ∞ patient–months (0 incidence in 5 months, p < 0.05). The incidence of gram-positive peritonitis in group C was 1 episode per 40.5 patient–months; in group M, the incidence was 1 episode per 365 patient–months ( p < 0.05). Mupirocin treatment had no significant effect on the incidence of exit-site infection and peritonitis attributable to other organisms. Before mupirocin treatment, we saw a trend toward higher infection rates in diabetic patients and nasal carriers of Staphylococcus aureus as compared with non diabetic patients and nasal non carriers, although the differences were not statistically significant. Mupirocin brought the infection rate attributable to gram-positive organisms to an equally low level in diabetic and non-diabetic patients, and in nasal carriers and nasal non carriers of S. aureus. No adverse effect of local application of mupirocin was reported. Conclusion Local application of mupirocin ointment at the catheter exit site is a safe and effective method of preventing exit-site infection and peritonitis involving gram-positive organisms.

First Case of CAPD-Related Peritonitis Caused byMorganella Morganii

2010 ◽  
Vol 30 (1) ◽  
pp. 119-121 ◽  
Author(s):  
H. Atalay ◽  
I. Güney ◽  
Y. Solak ◽  
E. Almaz
Keyword(s):  
Peritoneal Dialysis ◽  
Female Patient ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Morganella Morganii ◽  
Gram Negative ◽  
Negative Bacillus ◽  
First Case ◽  
Gram Negative Bacillus

Morganella morganii, a gram-negative bacillus, is a rare cause of peritonitis. In this article we report a 55-year-old female patient with peritonitis due to Morganella morganii who was receiving continuous ambulatory peritoneal dialysis (CAPD).

scholarly journals Unusual causes of peritonitis in patients undergoing continuous peritoneal dialysis with emphasis on Listeria monocytogenes.

1992 ◽  
Vol 3 (5) ◽  
pp. 1092-1097
Author(s):  
N M Lunde ◽  
J M Messana ◽  
R D Swartz
Keyword(s):  
Peritoneal Dialysis ◽  
Listeria Monocytogenes ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Antimicrobial Therapy ◽  
Catheter Removal ◽  
Gram Positive ◽  
Gram Negative ◽  
Streptococcus Species ◽  
Continuous Peritoneal Dialysis ◽  
Esrd Patients

Peritonitis remains a significant cause of morbidity in ESRD patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Staphylococcus species, Streptococcus species, and less commonly, gram-negative rods comprise the majority of isolated organisms. Other organisms, including unusual bacteria, fungi, and mycobacteria, comprise 5% or less of cases. Many of the uncommon causes of CAPD peritonitis have been reviewed, with special emphasis on antimicrobial therapy and whether catheter removal was required. The presumed third case of CAPD-associated peritonitis caused by Listeria monocytogenes is also described. In contrast to two other reported cases, our patient was not overtly immunosuppressed. L. monocytogenes infection should therefore be considered in CAPD patients with gram-positive rod peritonitis, even if immunocompetence is presumed.

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