Peritonitis in patients on continuous ambulatory peritoneal dialysis at Universitas Academic Hospital nephrology unit
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Date
2016-11
Authors
Mosia, Q. J.
Journal Title
Journal ISSN
Volume Title
Publisher
University of the Free State
Abstract
Background
Continuous ambulatory peritoneal dialysis (CAPD) is an important option for treatment of
end-stage renal disease (ESRD) in developing countries. Peritonitis remains the major
cause of CAPD failure, leading to patients discontinuing peritoneal dialysis (PD) and
switching to haemodialysis (HD). As access to haemodialysis is limited, it is important to
focus the attention on preventing peritoneal dialysis failure.
Objectives
To ascertain the microbiology profile in patients on CAPD presenting with peritonitis at the
Nephrology Unit at the Universitas Academic Hospital, to identify the antibiotic sensitivity
patterns of the causative organisms, and to determine the treatment outcome of this
complication.
Method
A descriptive retrospective study on 66 patients hospitalised between January 2005 and
December 2014 was carried out in Bloemfontein, South Africa.
Results
One hundred and twenty-three episodes of peritonitis were identified. 22.0% (n=27) of
these episodes were culture negative and 35.0% (n=43) were due to coagulase negative
staphylococcus. The coagulase negative staphylococcus episodes were sensitive to
cloxacillin in 53.5% and to vancomycin in 46.5%. The peritoneal dialysis catheter was
removed in 28.5% of the episodes; and the most frequent co-morbidity was hypertension –
in 48.5% (n=32) of the 66 patients.
Conclusion
The current empiric antibiotics remain appropriate for PD peritonitis. Coagulase negative
staphylococcus is confirmed as the most common cause of PD peritonitis at the unit.
CAPD units should be encouraged to adapt and optimise the general guidelines with
regard to local infections.
Description
Keywords
Peritonitis, Renal disease, Peritoneal dialysis (PD), Haemodialysis (HD), Antibiotics, Dissertation (M.Med. (Medicine))--University of the Free State, 2016