Evaluation of the Lysis-Centrifugation System for Culturing Dialysates From Continuous Ambulatory Peritoneal Dialysis Patients With Peritonitis

Forbes, Betty A.; Frymoyer, Paul A.; Kopecky, Richard T.; Wojtaszek, Jane; Pettit, David J.

doi:10.1016/s0272-6386(88)80208-7

Cited by 13 publications

(5 citation statements)

References 17 publications

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“…Investigators have found numbers of microorganisms in peritonitis that ranged from 1 CFU/ml to "too numerous to count" (36,40,82,116,136). Gram-positive organisms had higher mean counts than gram-negative rods (36,82,116).…”

Section: Cultivation Of Microorganisms General Principlesmentioning

confidence: 99%

“…It performed as well as the Isolator system (DuPont Co., Wilmington, Del.) with 10 ml of dialysate (40,155), although detection with the latter was 24 to 72 h earlier in 20% of the isolates (40 (82). A lower incubation temperature was favored for fungal cultures (156) and for psychrophiles such as P. fliuorescens (82), P. mesophilica (118), and Rhodotorula glutinis (154).…”

Section: Clin Microbiol Revmentioning

confidence: 99%

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Microbiological aspects of peritonitis associated with continuous ambulatory peritoneal dialysis

1992

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The process of continuous ambulatory peritoneal dialysis has provided a useful, relatively inexpensive, and safe alternative for patients with end-stage renal disease. Infectious peritonitis, however, has limited a more widespread acceptance of this technique. The definition of peritonitis in this patient population is not universally accepted and does not always include the laboratory support of a positive culture (or Gram stain). In part, the omission of clinical microbiological findings stems from the lack of sensitivity of earlier microbiological efforts. Peritonitis results from decreased host phagocytic efficiency with depressed phagocytosis and bactericidal capacity of peritoneal macrophages. During episodes of peritonitis, fluid movement is reversed, away from the lymphatics and peritoneal membrane and toward the cavity. As a result, bloodstream infections are rare. Most peritonitis episodes are caused by bacteria. Coagulase-negative staphylococci are the most frequently isolated organisms, usually originating from the skin flora, but a wide array of microbial species have been documented as agents of peritonitis. Clinical microbiology laboratories need to be cognizant of the diverse agents so that appropriate primary media can be used. The quantity of dialysate fluid that is prepared for culture is critical and should constitute at least 10 ml. The sensitivity of the cultural approach depends on the volume of dialysate, its pretreatment (lysis or centrifugation), the media used, and the mode of incubation. The low concentration of microorganisms in dialysate fluids accounts for negative Gram stain results. Prevention of infection in continuous ambulatory peritoneal dialysis patients is associated with the socioeconomic status of the patient, advances in equipment (catheter) technology, and, probably least important, the application of prophylactic antimicrobial agents.

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Section: Cultivation Of Microorganisms General Principlesmentioning

confidence: 99%

Section: Clin Microbiol Revmentioning

confidence: 99%

Microbiological aspects of peritonitis associated with continuous ambulatory peritoneal dialysis

1992

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“…However, comparative studies indicate that the minimum volume that should be tested is 10 ml (5,13,15,21). The method chosen should include an enrichment broth with antiphagocytic and lytic properties (3,18,19). Both centrifugation (12,13,20) and filtration (11)(12)(13)(14)20) have been tested as means of concentrating bacteria from CAPD effluents.…”

mentioning

confidence: 99%

Improved detection of bacterial growth in continuous ambulatory peritoneal dialysis effluent by use of BacT/Alert FAN bottles

et al. 1997

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Culture-negative peritonitis is a major complication for patients on continuous ambulatory peritoneal dialysis (CAPD) and precludes organism-specific therapy. The aim of the present study was to compare inoculation of 10 ml of CAPD effluent into BacT/Alert blood culture bottles (FAN [fastidious antimicrobic neutralizing], BacTAlert aerobic [BTA], and BacT/Alert anaerobic [BTAn] bottles) to our conventional method of using 50 ml of concentrated CAPD effluent to inoculate peptone broth bottles (BD bottles) and MacConkey agar and blood agar medium (BA-MAC). The FAN, BTA, and BTAn bottles were monitored automatically in the BacT/Alert blood culture instrument. A total of 207 CAPD effluents were studied, and in 97 bacteria were detected by at least one method. Compared to BTA bottles (79 of 97; 81.4%), BTAn bottles (78 of 97; 80.4%), and BD bottles (88 of 97; 90.7%), the single best broth medium for detecting bacterial growth in CAPD effluents was the FAN bottle (90 of 97 effluents; 92.8%). A total of 125 bacterial species were detected by any method, and the majority (91.8%) of CAPD effluents were infected with a single species. A combination of FAN and BTAn bottles detected 111 of 125 (88.8%) of all organisms, whereas a combination of BD bottles and BA-MAC detected 107 of 125 (85.6%) of all organisms. One or more organisms that would have been completely missed by the

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“…It performed as well as the Isolator system (DuPont Co., Wilmington, Del.) with 10 ml of dialysate (40,155), although detection with the latter was 24 to 72 h earlier in 20% of the isolates (40). In another study identification (but not isolation) was 24 to 48 h earlier with the Isolator than the BACTEC, and the Isolator performed equally as well as culture of 50 ml of plated and enriched centrifuged sample in nearly all respects (155).…”

Section: Downloaded Frommentioning

confidence: 93%

“…A few quantitative studies on dialysates have been done. Investigators have found numbers of microorganisms in peritonitis that ranged from 1 CFU/ml to "too numerous to count" (36,40,82,116,136). Gram-positive organisms had higher mean counts than gram-negative rods (36,82,116).…”

Section: General Principlesmentioning

confidence: 99%

Microbiological aspects of peritonitis associated with continuous ambulatory peritoneal dialysis.

Graevenitz

Amsterdam

1992

Clinical Microbiology Reviews

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Evaluation of the Lysis-Centrifugation System for Culturing Dialysates From Continuous Ambulatory Peritoneal Dialysis Patients With Peritonitis

Cited by 13 publications

References 17 publications

Microbiological aspects of peritonitis associated with continuous ambulatory peritoneal dialysis

Microbiological aspects of peritonitis associated with continuous ambulatory peritoneal dialysis

Improved detection of bacterial growth in continuous ambulatory peritoneal dialysis effluent by use of BacT/Alert FAN bottles

Microbiological aspects of peritonitis associated with continuous ambulatory peritoneal dialysis.

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