Peritonitis in Children Undergoing Continuous Ambulatory Peritoneal Dialysis

Powell, David; Luis, Elizabeth San; Calvin, Sadie; McDaid, Tarran; Potter, Donald

doi:10.1001/archpedi.1985.02140030031021

Cited by 8 publications

(6 citation statements)

References 14 publications

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“…Other investigators have reported the incidence of fungal peritonitis to vary from 5 to 15% of CAPD-associated peritonitis [2][3][4][5]. While a variety of fungal species have been isolated from peritoneal dialysate, Candida species are the predominant organisms [1][2][3][4][5][6][7], To our knowledge, the patient presented here is the first report of a CAPD-associated peritonitis due to an Aureobasidium species.…”

Section: Introductionmentioning

confidence: 81%

Continuous Ambulatory Peritoneal Dialysis Complicated by <i>Aureobasidium pullulans </i>Peritonitis

Clark

Silver²,

Hollick³

et al. 1995

Am J Nephrol

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We describe a case of peritonitis caused by Aureobasidium pullulans in a patient on continuous ambulatory peritoneal dialysis (CAPD). This dematiaceous fungus rarely causes infection in humans and to date has not been reported as an etiology of CAPD-associated peritonitis. The patient was managed successfully with peritoneal catheter removal and a prolonged course of intravenous amphotericin B, allowing resumption of CAPD. In vitro susceptibility testing confirmed sensitivity of this organism to amphotericin B.

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Section: Introductionmentioning

confidence: 81%

Continuous Ambulatory Peritoneal Dialysis Complicated by <i>Aureobasidium pullulans </i>Peritonitis

Clark

Silver²,

Hollick³

et al. 1995

Am J Nephrol

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“…Only about half of the peritonitis episodes developed in our patients in the first 5 postoperative days, suggesting that in some patients intraperitoneal introduction of bacteria was from another source. One possibility, as suggested by others [3], is that peritonitis may have been related to in-patient dialysis 151 started immediately postoperatively by staff not highly skilled in this technique, possibly leading to contamination at one of the connection points. Alternatively, it is possible that dialysis immediately post catheter insertion could impair normal tissue healing, causing or contributing to an increased dialysate leakage or tunnel infection rate.…”

Section: Discussionmentioning

confidence: 98%

Evaluation of perioperative antibiotics at the time of dialysis catheter placement

Sardegna

Beck

Strife

1998

Pediatric Nephrology

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The effect of prophylactic antibiotics on the occurrence of peritonitis in the 14 days following surgical peritoneal dialysis catheter placement was evaluated. Medical records from 73 pediatric patients who had 89 Tenckhoff catheters inserted over 6 years were reviewed. Twelve catheter procedures were excluded for rapid catheter loss, unavailable charts, eosinophilic peritonitis, and antibiotic administration > 3 h postoperatively. Chi-squared analysis for non-continuous variables compared factors at the time of catheter placement with outcome (peritonitis). Thirteen patients developed postoperative peritonitis when 77 catheter insertions were analyzed (17%). Peritonitis was significantly more common in patients who did not receive perioperative antibiotics (7 of 16 catheter placements) (chi(2) = 12.48, P < or = 0.001). The reduced incidence of peritonitis was not specific to any one antibiotic class. Using step-wise logistic regression analysis, no association was found between peritonitis incidence and nephrotic syndrome, immunosuppression, recent surgery (< 14 days), acute versus chronic use, year of catheter placement, surgeon, or patient age. Catheter type, implantation technique, exit site care, and operative wound care did not vary. These results indicate that perioperative peritonitis episodes can be significantly reduced by the use of prophylactic antibiotics prior to or at the time of surgery.

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“…Fungal peritonitis is a serious and potentially life-threatening complication of both intermittent peritoneal dialysis and continuous ambulatory peritoneal dialysis (CAPD). Investigators reviewing significant numbers of CAPD-associated fungal peritonitis episodes cite yeasts, particularly Candida species, as the predominant etiologic agents (10,12,13,20,29,37,38,50,52,53,54,58,61,63,65,66,68,73,78). Filamentous fungi complicating CAPD, although reported less frequently and fewer in number, encompass a wide array of agents, from the classic, systemic pathogens (4,42,45) to zygomycetous species (55,64) and members of numerous moniliaceous (3,11,16,25,27,30,33,39,40,48,51,57,67,71,75,76,77) and dematiaceous genera (1,2,6,7,…”

mentioning

confidence: 99%

“…Pathogenicity and identifying features. Fungal peritonitis in patients on CAPD, although significantly less frequent than bacterial peritonitis (3 to 15% versus Ͼ80%, respectively), is a well-documented clinical entity (13,38,54,65,78). Signs and symptoms are essentially the same in both presentations and may include cloudy dialysate effluent, dialysate leukocyte counts greater than 100/mm 3 , neutrophil counts greater than 50%, abdominal pain, distension, rigidity, nausea and vomiting, diarrhea, and fever.…”

mentioning

confidence: 99%

“…Not until hospital day 7 (episode day 28), with the report of a Candida species in the dialysate, was fluconazole therapy started. Although the route of infection is not clear, several reports have cited altered host flora due to prior or prolonged use of broad-spectrum antibacterial therapy as a significant risk factor and/or as being associated with the development of fungal peritonitis (13,38,54,65,78). Fungal cultures taken earlier in the course of this patient's episode or during the administration of antibacterial agents would have provided direction for more appropriate or additional antifungal therapy.…”

mentioning

confidence: 99%

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Fatal Hormonema dematioides Peritonitis in a Patient on Continuous Ambulatory Peritoneal Dialysis: Criteria for Organism Identification and Review of Other Known Fungal Etiologic Agents

et al. 1998

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We report a fatal case a fungal peritonitis caused by the yeast-like dematiaceous mould Hormonema dematioides in a 45-year-old woman. The woman had a 13-year history of insulin-dependent diabetes mellitus and had been on continuous ambulatory peritoneal dialysis for chronic renal failure. H. dematioides was repeatedly isolated from the dialysate culture specimens collected on days 3, 9, 16, and 20 of her hospital stay. Preliminary culture reports on day 7 of the growth of a yeast-like fungus, a probableCandida species, prompted the administration of fluconazole (FLU). Intraperitoneal and intravenous FLU failed to eliminate the mould, and the patient expired on day 21 of her hospital stay. We use this case to present what appears to be the first report of fungal peritonitis due to H. dematioides, to provide laboratorians with criteria for differentiating this organism from the similar mouldAureobasidium pullulans and from various yeast genera, and to provide a review of known fungal taxa inciting peritonitis.

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Peritonitis in Children Undergoing Continuous Ambulatory Peritoneal Dialysis

Cited by 8 publications

References 14 publications

Continuous Ambulatory Peritoneal Dialysis Complicated by <i>Aureobasidium pullulans </i>Peritonitis

Continuous Ambulatory Peritoneal Dialysis Complicated by <i>Aureobasidium pullulans </i>Peritonitis

Evaluation of perioperative antibiotics at the time of dialysis catheter placement

Fatal Hormonema dematioides Peritonitis in a Patient on Continuous Ambulatory Peritoneal Dialysis: Criteria for Organism Identification and Review of Other Known Fungal Etiologic Agents

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