ISPD Peritonitis Recommendations: 2016 Update on Prevention and Treatment

Li, Philip Kam-Tao; Szeto, Cheuk Chun; Piraino, Beth; Arteaga, Javier de; Fan, Stanley; Figueiredo, Ana Elizabeth; Fish, Douglas N.; Goffin, Éric; Kim, Yong-Lim; Salzer, William; Struijk, Dirk G.; Teitelbaum, Isaac; Johnson, David W.

doi:10.3747/pdi.2016.00078

Cited by 812 publications

(1,456 citation statements)

References 401 publications

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“…However, the causative organism may vary depending on the area and the environment and social background of patients. Treatment guidelines should be modified from time to time based on knowledge of recent, local epidemiological trends and susceptibility to antimicrobial agents, to try to improve patient outcomes [10].…”

Section: Introductionmentioning

confidence: 99%

Causative organisms and outcomes of peritoneal dialysis-related peritonitis in Sarawak General Hospital, Kuching, Malaysia: a 3-year analysis

Phui

Tan

Chen³

et al. 2017

Ren Replace Ther

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Background: Peritoneal dialysis peritonitis remains a significant cause of morbidity for peritoneal dialysis patients and the main reason for conversion from peritoneal dialysis to hemodialysis. As the characteristics of patients and microbial susceptibility vary from center to center, the aim of this study is to evaluate the microbiology and the clinical outcomes among continuous ambulatory peritoneal dialysis patients in Kuching, Malaysia. Methods: This is a retrospective record review of 82 continuous ambulatory peritoneal dialysis patients who developed peritonitis during 2013 to 2015. Data examined included patients' demographic data, causative organisms, and outcomes. Results: A total of 124 episodes of peritonitis were recorded, and the overall peritonitis rate was 0.40 episodes per patient-year. There was an increasing incidence in continuous ambulatory peritoneal dialysis peritonitis over the 3-year study period (0.35 to 0.47 episodes per patient-year). The gram-negative peritonitis rate increased over the period until towards the end of the study period, when gram-positive and gram-negative organisms accounted for almost equal proportions of peritonitis. Streptococcus sp. was the most common organism among the gram-positive peritonitis while Pseudomonas sp. was the most common organism in gram-negative peritonitis. The culture-negative peritonitis rate was 25.8%. The peritoneal dialysis catheter was removed in 32 episodes (26.6%). The catheter loss rate was significantly higher in gram-negative peritonitis, as compared to gram-positive peritonitis (38.9 vs 16.7%, p = 0.027). Conclusions: The increasing trend of peritonitis and high rates of culture negativity and peritoneal dialysis catheter removal are areas that need further evaluation and improvement in the future. Study on risk factors of continuous ambulatory peritoneal dialysis peritonitis, detailed microbiology, and antimicrobial treatment and response are warranted to further improve the outcomes of continuous ambulatory peritoneal dialysis patients.

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Section: Introductionmentioning

confidence: 99%

Causative organisms and outcomes of peritoneal dialysis-related peritonitis in Sarawak General Hospital, Kuching, Malaysia: a 3-year analysis

Phui

Tan

Chen³

et al. 2017

Ren Replace Ther

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“…5,6 From these bags, 100ml of fluid was withdrawn with a sterile needle and syringe under aseptic conditions. The fluid was centrifuged in sterile tubes at a rate of 3000g for 15 minutes and supernatant was discarded, leaving 0.5ml.…”

Section: Methodsmentioning

confidence: 99%

Dialysate color and its role in presumptive diagnosis of dimorphic fungi in peritoneal dialysis associated fungal peritonitis

Narain¹,

Gupta

2017

Int J Adv Med

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Background: Fungal peritonitis is a rare but serious complication of peritoneal dialysis (PD). Dimorphic fungi are described in peritonitis at a much lower percentage than yeasts are, but their involvement in it is growing.Methods: The study was based on the analysis of available data over a period of 16 years. The sample size was of 421 ESRD patients on CAPD. We retrospectively identified 72 cases of fungal peritonitis. In the present study we assessed the frequency of dimorphic fungi as a single pathogen, its association with the dialysate colour along with the predictors and its impact on the outcome of the patients.Results: In between January 2000 and October 2016, in present retrospective study, we identified 72 episodes of peritoneal dialysis associated with fungal peritonitis. Among the 72 fungal episodes, 83.3% were Candida species, 1.5% were yeast and the remaining 15.2% were dimorphic fungi. The macrolevel observations of dialysate showed greyish, blackish, greenish, pinkish, cloudy, bluish green and cloudy colours that developed due to the pigmentation of fungi and fungal spores. The Aspergillus species predominates amongst the dimorphic fungi. Outcome analysis revealed that the loss of life (14.7%) was more frequent in diabetics while the reinsertion of catheter failed in cases of glomerulonephritis. It was also noticed that de novo infections were more frequent among the diabetics and that the previous bacterial peritonitis episode was the strongest predictor amongst them all.Conclusions: The premise of the current study illustrates the fact that the dialysate colour can be put to use as an early warning system and by combining the macroscopic observations of the dialysate with the results of microscopy and culture, the diagnosis of Fungal peritonitis due to dimorphic fungi will not be missed. Also worth noting is the point that an early assessment of predictors alongside that of an antifungal coverage can lead to a reduction in the rates of morbidity which in turn will shorten the stay in hospital. This will prevent any further nosocomial infection, antifungal resistance and chances of treatment failure.

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“…Although fungal peritonitis is not common, yeast infection with the most common Candida species results in a poor outcome with high mortality [53][54][55]. The 2016 International Society for Peritoneal Dialysis guidelines recommends removal of the PD catheter in fungal peritonitis [56]. Several clinical observations have suggested that EPS could be induced by a single occurrence of fungal peritonitis [56][57][58][59][60].…”

Section: Zymosan-induced Fungal Peritonitis Modelmentioning

confidence: 99%

“…The 2016 International Society for Peritoneal Dialysis guidelines recommends removal of the PD catheter in fungal peritonitis [56]. Several clinical observations have suggested that EPS could be induced by a single occurrence of fungal peritonitis [56][57][58][59][60]. The cell walls of many types of yeast activate various signaling reactions, including the complement system [61].…”

Section: Zymosan-induced Fungal Peritonitis Modelmentioning

confidence: 99%

Peritonitis-induced peritoneal injury models for research in peritoneal dialysis review of infectious and non-infectious models

et al. 2017

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Peritonitis is an important complication of peritoneal dialysis. Several animal peritonitis models have been described, including bacterial and fungal models that are useful for studying inflammation in peritonitis. However, these models have limitations for investigating peritoneal fibrosis induced by acute inflammation and present difficulties in handling the infected animals. Animal models of peritonitis which induced peritoneal fibrosis are important for establishing new therapies to improve peritoneal damage induced by peritonitis. Here, we present an overview of representative animal models of peritoneal dialysis-associated infectious and non-infectious peritonitis, including our novel animal models (scraping and zymosan models) that mimic peritoneal injury associated with fibrosis and neoangiogenesis caused by bacterial or fungal peritonitis.

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ISPD Peritonitis Recommendations: 2016 Update on Prevention and Treatment

Cited by 812 publications

References 401 publications

Causative organisms and outcomes of peritoneal dialysis-related peritonitis in Sarawak General Hospital, Kuching, Malaysia: a 3-year analysis

Causative organisms and outcomes of peritoneal dialysis-related peritonitis in Sarawak General Hospital, Kuching, Malaysia: a 3-year analysis

Dialysate color and its role in presumptive diagnosis of dimorphic fungi in peritoneal dialysis associated fungal peritonitis

Peritonitis-induced peritoneal injury models for research in peritoneal dialysis review of infectious and non-infectious models

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