Peritonitis in Paediatric Continuous Peritoneal Dialysis

Tranæus, Anders

doi:10.1007/978-1-4615-4931-4_19

Cited by 12 publications

(17 citation statements)

References 244 publications

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“…The type of organism that causes peritonitis affects the outcome [9,13,15]. Compared to the other organisms, peritonitis caused by MRSA or fungi was associated with worse outcomes in our survey.…”

Section: Discussionmentioning

confidence: 90%

“…In a survey of Japanese adults, S. aureus was also the most common organism, detected in 20% of 448 episodes of peritonitis from 1994 to 1996 [2]. However, in reports from other countries on adults [10][11][12] and on children [9,[13][14][15], the most common organism remains CNS. One explanation for this difference might be the low rate of touch contamination as a cause of peritonitis in our survey, thereby reducing the incidence of coagulase-negative staphylococcal peritonitis.…”

Section: Discussionmentioning

confidence: 98%

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A survey of peritonitis and exit-site and/or tunnel infections in Japanese children on PD

2006

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To obtain data on peritonitis and exit-site and/or tunnel infections (ESI/TI) in Japanese children undergoing peritoneal dialysis (PD) from January 1999 through June 2003, we surveyed 22 members of the Japanese Study Group of Pediatric Peritoneal Dialysis (JSPPD) by questionnaire. One hundred and thirty patients were eligible. Seventy episodes of bacterial peritonitis occurred in 45 patients (0.17 episodes/patient-year), and 123 ESI/TI occurred in 60 patients (0.29 episodes/patient-year). S. aureus and MRSA were found to be the causative organisms in 39% and 13% of the peritonitis episodes, and in 59% and 20% of the ESI/TI, respectively. Tunnel infection was found in 55% of the MRSA peritonitis episodes. Eleven percent of the peritonitis episodes relapsed, and 19% needed hemodialysis. One patient died due to MRSA peritonitis. The PD catheter was removed in all fungal and 78% of MRSA peritonitis. However, the type of organism did not influence the need for catheter-related surgery for ESI/TI. Neither peritonitis nor ESI/TI was prevented by the use of a swan-neck catheter, a downward-pointing exit site, povidone iodine exit-site care, bathing instruments, or nasal mupirocin. In conclusion, MRSA peritonitis was not uncommon in children in Japan, was frequently associated with tunnel infections, and had a poor outcome. No association was found between the occurrence of infection and preventive measures previously reported as effective. Alternative approaches are needed in children, especially for MRSA.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 98%

A survey of peritonitis and exit-site and/or tunnel infections in Japanese children on PD

2006

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“…It is generally agreed that by following recommended culture techniques, culture-negative peritonitis should not account for Ͼ20% of peritonitis episodes. 3,17,18 Evaluation of those sites with frequent culture-negative episodes is now being undertaken. Finally, although a higher incidence of Gram-negative infections in infants ("diaper peritonitis") has repeatedly been suggested in clinical reviews, we confirm for the first time a statistical association of young age and Gram-negative infection.…”

Section: Discussionmentioning

confidence: 99%

Peritonitis in Children Who Receive Long-Term Peritoneal Dialysis

Warady¹,

Feneberg

Verrina³

et al. 2007

Journal of the American Society of Nephrology

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In children who are on chronic peritoneal dialysis, peritonitis is the primary complication compromising technique survival, and the optimal therapy of peritonitis remains uncertain. An Internet-based International Pediatric Peritonitis Registry was established in 47 pediatric centers from 14 countries to evaluate the efficacy and safety of largely opinion-based peritonitis treatment guidelines in which empiric antibiotic therapy was stratified by disease severity. Among a total of 491 episodes of nonfungal peritonitis entered into the registry, Gram-positive organisms were cultured in 44%, Gram-negative organisms were cultured in 25%, and cultures remained negative in 31% of the episodes. In vitro evaluation revealed 69% sensitivity of Grampositive organisms to a first-generation cephalosporin and 80% sensitivity of Gram-negative organisms to a third-generation cephalosporin. Neither the risk factors assumed by the guidelines nor the choice of empiric therapy was predictive of either the early treatment response or the final functional outcome of the peritonitis episodes. Overall, 89% of cases achieved full functional recovery, a portion after relapsing peritonitis (9%). These data serve as the basis for new evidence-based guidelines. Modification of empiric therapy to include aminoglycosides should be considered.

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“…4,10,12,13,14,15 Other dialysis complications, such as infections, especially infections of the peritoneal catheter exit site and tunnel, have been reported by six (20%) caregivers, being usually associated with poor hygiene, manipulation by patients and/or colonization by bacteria of their own skin, predisposing to peritonitis.…”

Section: Hospitalizations and Peritonitismentioning

confidence: 99%

“…4,5 One of the first signs of peritonitis is the alteration in color and aspect of the fluid drained that changes from clear and thin to cloudy and thick. In addition, there are …”

Section: Introductionmentioning

confidence: 99%

Fatores de risco para peritonites e internações

Abrahão¹,

Ricas²,

Andrade³

et al. 2010

J. Bras. Nefrol.

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Introduction: This study assessed 30 children and adolescents with chronic kidney disease on dialysis, cared for at the Hospital das Clínicas of UFMG, aiming at determining the risk factors for the frequency of peritonitis and hospitalizations. Method: Descriptive study using the SPSS (Statistical Package for Social Science) software, version 13.0. The following variables were assessed as risk factors for a higher frequency of peritonitis and hospitalizations: low educational level; low family income; inadequate level of information; inadequate hand antisepsis during PD; and lack of a sink in the dialysis room. Results: The odds ratio values were within the 95% confidence intervals, and, in some cases, were smaller than 1, indicating the possibility of a negative association between some independent variables and the variables studied, but with no statistically significant difference. Conclusion: No statistical significance was observed for the variables studied, despite the tendency towards that.

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Peritonitis in Paediatric Continuous Peritoneal Dialysis

Cited by 12 publications

References 244 publications

A survey of peritonitis and exit-site and/or tunnel infections in Japanese children on PD

A survey of peritonitis and exit-site and/or tunnel infections in Japanese children on PD

Peritonitis in Children Who Receive Long-Term Peritoneal Dialysis

Fatores de risco para peritonites e internações

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