Laboratory Diagnosis and Oral Treatment of Capd Peritonitis

Knight, Kenneth R.; Polak, Anna; Crump, John A.; Maskell, Rosalind

doi:10.1016/s0140-6736(82)91509-4

Cited by 79 publications

(41 citation statements)

References 3 publications

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“…The number of positive cultures from the pellets (sediments) was even significantly smaller than that from the uncentrifuged plated samples; however, the percentage of cultures with c5 CFU/50 ml of dialysate was higher (41 versus 19%) in the uncentrifuged sample (82). Another study found enrichment of 2 to 3 ml of dialysate to be superior to culture of the pellets from 10 ml of dialysate and of 0.5 ml of uncentrifuged samples (68). Washing of the centrifuged sediment did (144) or did not (50) increase the yield over that of direct plating.…”

Section: Results Of Recent Studiesmentioning

confidence: 96%

“…Cloudiness generally reflects a WBC count of >100/mm3. Fluids with WBC counts of 50 to 100/mm3 may or may not be cloudy (68). In rare instances, cloudiness may also be caused by fibrin, chyle, blood (e.g., from menstruation), peritonitis from another source (156), or accumulation of PMs if dialysate dwell times are prolonged beyond 10 h (39).…”

Section: Cell Count and Turbiditymentioning

confidence: 99%

“…There is unanimity that the sensitivity of the Gram stain (even on centrifuged samples) and the acridine orange stain (139) is low. Because of the low concentration of microorganisms in the dialysate, tinctorial sensitivity compared with that of culture results has been reported to range only between 10 and 50% (36,68,90,115,116). Gram-positive organisms may have a higher chance of being detected on Gram stain than gram-negative ones (82).…”

Section: Microbiological Findingsmentioning

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: Results Of Recent Studiesmentioning

confidence: 96%

Section: Cell Count and Turbiditymentioning

confidence: 99%

Section: Microbiological Findingsmentioning

confidence: 99%

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Microbiological aspects of peritonitis associated with continuous ambulatory peritoneal dialysis

1992

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“…The first indications of peritonitis are generalised abdominal pain in the presence of a cloudy effluent containing > 100 x 10 6 /l white blood cells (85% polymorphonuclear cells [PMNs]). 46 Cell counts of 50-100 x 10 6 /l may result in a cloudy effluent 47 and for this reason the PMN cell percentage may be a more useful indicator of infection. 48 There have been reports of non-bacterial, non-specific eosinophilic peritonitis in peritoneal dialysis patients.…”

Section: Peritoneal Dialysis Peritonitismentioning

confidence: 99%

The surgical management of peritoneal dialysis catheters

Brook

White²,

Waller³

et al. 2004

Ann R Coll Surg Engl

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“…3 Aplastic crisis associated with HPV infection has hitherto only been described in hereditary2 [4][5][6] The isolation of campylobacter like organisms from the gastric mucosa of ferrets was first reported from Boston, USA' 6; this organism, with morphological similarities to Cpylori, was isolated from about half of the animals examined. Histological studies suggested a possible association between the presence of the campylobacter and gastric inflammation.…”

mentioning

confidence: 99%

Comparative sensitivities to antimicrobial agents of Campylobacter pylori and the gastric campylobacter like organism from the ferret.

Jeffries¹,

Buckley²,

Blower³

et al. 1987

J Clin Pathol

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1265row showed erythrobastopenia (less than 1% of erythroblasts). The presence of serum anti-HPV IgM (radioimmunoassay) suggested a recent HPV infection. Packed red cells (600 ml) were transfused. Over the next few days the symptoms disappeared and haemoglobin concentrations remained stable. Ten days after admission reticulocyte count was 150 x 109/1. Eighteen months later, the patient was quite well and all haematological investigations yielded normal results blood count, haemoglobin electrophoresis, erythrocytic enzymes (glucose-6-phosphate-deshydrogenase, glucose-phosphogluconate-deshydrogenase, hexokinase, glucose-isomerase-phosphate, glucose-pyruvate, glutathione reductase, acetyl-cholinesterase, pyrimidine-5'-nucleotidase), osmotic resistance and autohaemolysis.Our observation of HPV infection associated with aplastic crisis but without haemolysis differs from the transient erythroblastopenia seen in childhood, which often affects younger children (1 to 4 years) and occurs without HPV infection.3Aplastic crisis associated with HPV infection has hitherto only been described in hereditary2 4-6 or acquired' haemolytic anaemias. It seems that the erythroblastopenic effect of HPV is constant but goes unnoticed if the red cell life span is normal. A shortened red cell survival (haemolysis) is necessary to cause acute anaemia. Acute anaemia occurring without haemolysis due to an HPV infection is difficult to explain. In our patient only isotopic labelling of his erythrocytes could have completely excluded underlying haemolysis. Nonetheless, we wanted to record the experience to encourage doctors to ask for parvovirus serology in similar clinical circumstances.

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Laboratory Diagnosis and Oral Treatment of Capd Peritonitis

Cited by 79 publications

References 3 publications

Microbiological aspects of peritonitis associated with continuous ambulatory peritoneal dialysis

Microbiological aspects of peritonitis associated with continuous ambulatory peritoneal dialysis

The surgical management of peritoneal dialysis catheters

Comparative sensitivities to antimicrobial agents of Campylobacter pylori and the gastric campylobacter like organism from the ferret.

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