Peritonitis in patients on continuous ambulatory peritoneal dialysis at Universitas Academic Hospital nephrology unit
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.