Peritonitis

Vas, Stephen I.

doi:10.1007/978-94-009-1085-0_14

Cited by 42 publications

(19 citation statements)

References 165 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The most frequent organisms encountered in our patients were basically the same as previously reported by other authors [1,10,12]: Staphylococcus species with MIC 90 of 0.02-0.08 Ìg/ml; Streptococcus species with MIC 90 of 0.001 to 0.002 Ìg/ml; Escherichia coli with MIC 90 of 0.06-0.4 Ìg/ml, Klebsiella with MIC 90 of 0.1 to 1.0 Ìg/ml and P. aeruginosa with MIC 90 of 0.03-0.06 Ìg/ml. These MIC 90 values contrast with the much higher drug levels attained with the dosing schedule employed in the present study ( fig.…”

Section: Resultssupporting

confidence: 79%

“…The frequency of infections in this population is in part due to the immunosuppressive effects of uremia [1,[4][5][6][7][8][9], but a significant added factor is the frequent violation of the integrity of the vascular system with each hemodialysis session [1], or of the peritoneal cavity with the daily exchange of peritoneal dialysis fluid and the manipulation of the peritoneal catheter [3,[10][11][12]. The most frequent Trimarchi/Lafuente/Suki organisms encountered in ESRD patients are Staphylococcus species, Streptococcus species, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa [1,[10][11][12]. Heretofore, the most common initial approach to the treatment of infections in ESRD patients has been the concurrent use of an intravenous loading dose of vancomycin and of an aminoglycoside followed by the respective maintenance dose of each drug.…”

confidence: 99%

See 1 more Smart Citation

Ceftriaxone Is an Efficient Component of Antimicrobial Regimens in the Prevention and Initial Management of Infections in End-Stage Renal Disease

2000

View full text Add to dashboard Cite

Background: Infection is a frequent complication in patients with end-stage renal disease. The most common organisms isolated are gram-positive cocci and gram-negative bacilli. Therefore, the usual initial therapeutic approach in these situations is the simultaneous intravenous administration of vancomycin plus an aminoglycoside. This treatment's adverse effects include ototoxicity, nephrotoxicity, and less than ideal tissue penetrance. Methods: We assessed the efficacy of intravenous ceftriaxone in the prevention and in the initial empirical treatment of infections in end-stage renal disease patients, and tested the stability of blood levels of this antibiotic in this population. We studied 104 patients, 65 of them falling into the prevention group (1 g of ceftriaxone i.v. for 5 days) and 39 into the treatment group (1 g of ceftriaxone i.v. or intraperitoneally for 10-14 days). Results: Peak serum ceftriaxone concentrations were well above the minimal inhibitory concentration for 90% of strains. Trough serum concentrations of the drug prior to the next dose were also considerably in excess of the minimal inhibitory concentration. In the prevention group, 8 of 65 developed an infection, which was sensitive to ceftriaxone, whereas in 22 of the 39 patients from the treatment group, cultures showed organisms sensitive to ceftriaxone and in the remaining 17 patients sensitivity was not done. Conclusions: The present study demonstrates the efficacy of a simplified dosing schedule in achieving blood levels of the antibiotic well in excess of minimal inhibitory concentration of any of the organisms encountered. It also shows the usefulness of ceftriaxone in the prevention and/or treatment of bacterial infections and the lack of the side effects vancomycin and/or aminoglycosides possess.

show abstract

Section: Resultssupporting

confidence: 79%

confidence: 99%

Ceftriaxone Is an Efficient Component of Antimicrobial Regimens in the Prevention and Initial Management of Infections in End-Stage Renal Disease

2000

View full text Add to dashboard Cite

show abstract

“…Two main routes of bacterial invasion into the peritoneal cavity during CAPD are intraluminal and periluminal routes [9]. The intraluminal infection occurs when the bacteria enter the peritoneal cavity via the internal pathway of the peritoneal dialysis tubing through touch contamination or through cracks developed in the tubing.…”

Section: Discussionmentioning

confidence: 99%

“…Peritonitis is the most common cause of CAPD drop out [7][8][9][10]. Two main routes of bacterial invasion into the peritoneal cavity during CAPD are intraluminal and periluminal routes [9].…”

Section: Discussionmentioning

confidence: 99%

Effect of Prolonged Subcutaneous Implantation of Peritoneal Catheter on Peritonitis Rate during CAPD: A Prospective Randomized Study

Park¹,

Yim²,

Chung³

et al. 1998

Blood Purif

View full text Add to dashboard Cite

We conducted a prospective randomized controlled study to confirm our earlier observation that prolonged subcutaneous implantation of peritoneal catheter reduced peritonitis rate when compared to retrospective data from patients with catheters placed by conventional access technique. A total of 60 patients were randomized into two groups: 30 patients had catheters left implanted subcutaneously for 6 weeks (I) and the other 30 patients had catheters inserted by conventional technique and had 6 weeks of break-in period (C). Subgroups of 15 patients each with new and conventional techniques used Y-connector (IY, CY) and remaining patients used standard spikes (IS, CS).Mean age was 47.7 years (range 16–71); 61.0% were male and 44.1% diabetics. Peritonitis, exit site infection, simultaneous peritonitis and exit site infection, and complication related to Staphylococcus or Pseudomonas infections were observed for up to 2 years in each patient after initiation of bag exchange or until termination of CAPD by transfer to hemodialysis or by death.Total duration of observation was 493.2 patient-months for new access technique and 409.6 patient-months for conventional technique. Patients in IY group had the lowest incidence of peritonitis (1/14.9 patient-months) and exit site infection (1/16.8 patient-months) among four subgroups. Peritonitis rate in IY was significantly lower compared to CY or CS. The total peritonitis-free period in those patients who did not experience peritonitis during the observation period was also significantly longer in IY (120 patient-months) than in CY (26 patient-months), IS (10.6 patient-months), or CS (10.4 patient-months). Simultaneous peritonitis and exit site infection was observed in none of IY group but 3 episodes in CY, 4 episodes in IS, and 3 episodes in CS. The rates of complications related to Staphylococcus aureus and Pseudomonas infections were also significantly lower in IY than in CY, IS, or CS. Technique survival did not differ between the two groups.The present results confirm our previous observation that the new access technique reduces the incidence of peritonitis probably by reducing infection via periluminal route. The Y-connector system further reduces peritonitis rate by reducing infection via intraluminal route.

show abstract

“…Although relapse during therapy is easily defined, the differentiation between recurrence (defined as the reappearance of symptomatic peritonitis within 2 weeks of completing apparently successful therapy) and re-infection (defined as an apparently new episode of peritonitis beyond this 2-week interval) is much more difficult and these definitions [12] in any case are based on the reappearance of the symptomatic disease, rather than microbiological data. Proof that the same organism was responsible in such difficult circumstances would help clarify this problem.…”

Section: Discussionmentioning

confidence: 99%

Rapid inter-strain comparison by pyrolysis mass spectrometry of coagulase-negative staphylococci from persistent CAPD peritonitis

et al. 1991

View full text Add to dashboard Cite

SUMMARYPyrolysis mass spectrometry (PyMS) was used as a method of rapid inter-strain comparison of 19 isolates of coagulase-negative staphylococci from episodes of CAPD peritonitis. Thirteen isolates were from multiple, but distinct, episodes of peritonitis in 6 patients and the remaining 6 isolates were from 6 patients with single episodes. The results, expressed in terms of identity/non-identity of strains, were compared with those obtained using an established typing system comprising an extended antibiogram, determination of biotype and plasmid profile analysis. The PyMS results for inter-strain comparison were in agreement with the reference typing scheme results. PyMS can be used in this setting to rapidly obtain evidence that persistent infection is/is not likely to be due to the same organism, although it cannot be used for formal typing. The results by both methods showed that serial, apparently distinct, episodes of peritonitis over periods as long as 120 days may be due to the same strain of coagulase-negative staphylococcus. Clinically based distinctions between recurrence of infection (same strain) and re-infection (different strains) may not always be supported by the microbiological evidence.

show abstract

Peritonitis

Cited by 42 publications

References 165 publications

Ceftriaxone Is an Efficient Component of Antimicrobial Regimens in the Prevention and Initial Management of Infections in End-Stage Renal Disease

Ceftriaxone Is an Efficient Component of Antimicrobial Regimens in the Prevention and Initial Management of Infections in End-Stage Renal Disease

Effect of Prolonged Subcutaneous Implantation of Peritoneal Catheter on Peritonitis Rate during CAPD: A Prospective Randomized Study

Rapid inter-strain comparison by pyrolysis mass spectrometry of coagulase-negative staphylococci from persistent CAPD peritonitis

Contact Info

Product

Resources

About