Fungal peritonitis in a large chronic peritoneal dialysis population: a report of 55 episodes

Goldie, Sue J.; Kiernan-Troidle, Laura; Torres, Carlos; Gorban-Brennan, Nancy; Dunne, Dana; Kliger, Alan S.; Finkelstein, Frederic O.

doi:10.1016/s0272-6386(96)90135-3

Cited by 165 publications

(192 citation statements)

References 13 publications

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“…In a pediatric study of 51 patients with FP, prompt therapy resulted in preservation of the peritoneal membrane and continued PD in most patients (130). A somewhat similar experience has also been documented in adults (128). Several factors appear to predispose patients to the development of FP, the most common of which is the prior use of antibiotics to treat bacterial peritonitis or a catheter-related infection (123,128,131).…”

Section: Research Recommendationsmentioning

confidence: 79%

“…Observational studies suggest that frequent peritonitis, particularly episodes with gram-negative organisms, recent antibiotic therapy, and immunosuppression, can all be risk factors for FP in adults and in children (125,(127)(128)(129)(130). Warady et al (130) found that 56% of children with FP had received antibiotics in the preceding month, half of them for bacterial peritonitis.…”

Section: Rationalementioning

confidence: 99%

“…Candida albicans can grow on Silastic surfaces, and biofilm production has been associated with the development of C .albicans peritonitis (231). Most significant is the fact that, compared with patients treated with either antifungal therapy or catheter removal alone, the risk of repeat FP and death was lowest in patients treated with both interventions simultaneously (123,128,232) (see guideline 17).…”

Section: Guideline 14 -Modification Of Therapy For Fungal Peritonitismentioning

confidence: 99%

See 2 more Smart Citations

Consensus Guidelines for the Prevention and Treatment of Catheter-Related Infections and Peritonitis in Pediatric Patients Receiving Peritoneal Dialysis: 2012 Update

et al. 2012

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Section: Research Recommendationsmentioning

confidence: 79%

Section: Rationalementioning

confidence: 99%

Section: Guideline 14 -Modification Of Therapy For Fungal Peritonitismentioning

confidence: 99%

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Consensus Guidelines for the Prevention and Treatment of Catheter-Related Infections and Peritonitis in Pediatric Patients Receiving Peritoneal Dialysis: 2012 Update

et al. 2012

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“…Hemodialysis access can be an arteriovenous prosthetic graft, an arteriovenous fistula, or a catheter. Associated infection rates per patient-day are the lowest with arteriovenous fistulae, followed by grafts, tunneled or cuffed catheters, and nontunneled or noncuffed catheters (39,61). Bacteria account for the majority of cases of hemodialysis-related infections.…”

Section: Dialysis Accessmentioning

confidence: 99%

Candida Infections of Medical Devices

2004

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The number of indwelling medical devices is escalating, and an increasing proportion of device-related infections are being caused by Candida spp. Candida spp. produce biofilms on synthetic materials, which facilitates adhesion of the organisms to devices and renders them relatively refractory to medical therapy. Management of device-related Candida infections can be challenging. Removal of the infected device is generally needed to establish cure of Candida infections of medical devices. However, since the pathogenesis of Candida bloodstream infection is complicated, more studies are necessary to determine the role of catheter exchange in patients with both gastrointestinal tract mucositis and indwelling catheters. The medical and economic impact of these infections is enormous

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“…7 Goldie et al studied antibiotic usage in patients who developed FP and found that 65% of patients had received broad-spectrum antibiotics within 1 month, 74% in 3 months, and 97% in 6 months preceding an episode of FP. 8 The International Society for Peritoneal Dialysis (ISPD)'s PD-related infections recommendation (2005 update) states that fungal prophylaxis during antibiotic therapy may be beneficial in programs with high FP rates. 9 However, consensus continues to be elusive regarding the optimal agent, dose, and duration of prophylaxis against FP.…”

Section: Introductionmentioning

confidence: 99%

Prophylaxis against fungal peritonitis in CAPD – a single center experience with low-dose fluconazole

et al. 2010

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Background/aims: Fungal peritonitis (FP) significantly alters the outcome of patients on peritoneal dialysis (PD). Exposure to antibiotics is a risk factor for subsequent FP. Antifungal prophylaxis has been tried, with varying success, to prevent the occurrence of antibiotic-related fungal peritonitis (AR-FP). We aimed to evaluate the effect of prophylaxis with a low dose of fluconazole, in preventing AR-FP. Methods: In this retrospective review, we examined the incidence of FP in a cohort of 115 patients, who had received antibiotics for bacterial peritonitis and received a co-prescription of fluconazole, 50 mg/day for the duration of antibiotic therapy. The incidence of bacterial peritonitis and FP for up to 3 months after antibiotic therapy was noted. Results: One hundred and fifteen patients were followed up over a 6-year period, for 2549 patient-months. We observed 82 episodes of bacterial peritonitis and a total of 137 antibiotic prescriptions. The peritonitis rate was 1 episode per 31.08 patient-months (1 per 2.58 patient-year, 0.38 episodes every patient-year). We had six episodes of FP. There were no episodes of AR-FP. Conclusion: We observed very low rates of both bacterial peritonitis and FP, and prophylaxis with low-dose fluconazole seemed to confer protection against AR-FP. We did not encounter any adverse effects with its use.

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Fungal peritonitis in a large chronic peritoneal dialysis population: a report of 55 episodes

Cited by 165 publications

References 13 publications

Consensus Guidelines for the Prevention and Treatment of Catheter-Related Infections and Peritonitis in Pediatric Patients Receiving Peritoneal Dialysis: 2012 Update

Consensus Guidelines for the Prevention and Treatment of Catheter-Related Infections and Peritonitis in Pediatric Patients Receiving Peritoneal Dialysis: 2012 Update

Candida Infections of Medical Devices

Prophylaxis against fungal peritonitis in CAPD – a single center experience with low-dose fluconazole

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