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Pseudomonas Peritonitis and Continuous Ambulatory Peritoneal Dialysis

Pseudomonas Peritonitis and Continuous Ambulatory Peritoneal Dialysis Abstract In a population of 44 patients receiving continuous ambulatory peritoneal dialysis (CAPD) for a total of 591 patient months, there were 104 episodes of peritonitis. The organisms were gram-positive in 65.4%, gram-negative in 23.1%, and cultures of the dlalysate were sterile in 11.5%. Pseudomonas aeruginosa was the most frequently encountered gram-negative organism, accounting for 38.5% of the gram-negative infections or 9.6% of all infections. In all cases of P aeruginosa peritonitis, aminoglycoside antibiotic therapy for up to four weeks failed to eradicate the infection, and all patients required removal of the Tenckhoff catheter because of the presence of a sinus tract infection. We conclude that P aeruginosa is the most frequent cause of gram-negative peritonitis in patients receiving CAPD. The presence of a sinus tract infection should be suspected in all patients in whom peritonitis secondary to this organism develops. Removal of the Tenckhoff catheter will be required to cure the peritoneal infection. (Arch Intern Med 1982;142:1862-1863) References 1. Popovich RP, Moncrief JW, Dechard JB et al: The definition of a novel portable/wearable equilibrium peritoneal dialysis technique, abstracted. Am Soc Artif Intern Organs 1976;5:64. 2. Popovich RP, Moncrief JW, Nolph KD, et al: Continuous ambulatory peritoneal dialysis. Ann Intern Med 1978;88:449-456.Crossref 3. Oreopoulos DG, Robson M, Faller B, et al: Continuous peritoneal dialysis: A new era in the treatment of chronic renal failure. Clin Nephrol 1979;11:125-128. 4. Lacke C, Senekjian HO, Knight TF, et al: Twelve months' experience with continuous ambulatory and intermittent peritoneal dialysis. Arch Intern Med 1981;141:187-190.Crossref 5. Rubin J, Rogers WA, Taylor HM, et al: Peritonitis during continuous ambulatory peritoneal dialysis. Ann Intern Med 1980;92:7-13.Crossref 6. Faller B, Marichal JF: Treatment of chronic renal failure: Situation of CAPD. Int J Artif Organs 1980;3:243-244. 7. Nolph KD, Sorkin MI: Diagnosis and treatment of peritonitis , in Moncrief JW, Popovich RP (eds): CAPD Update . New York, Masson Publishing USA Inc, 1981, pp 265-272. 8. Vas S: Microbiological aspects of peritonitis. Peritoneal Dialysis Bull 1981;1:S11-S14. 9. Oreopoulos DG, Vas S, Khanna R: Treatment of peritonitis (in patients on CAPD) , in Moncrief JW, Popovich RP (eds): CAPD Update . New York, Masson Publishing USA Inc, 1981, pp 259-264. 10. Oreopoulos DG, Williams P, Khanna R, et al: Treatment of peritonitis. Peritoneal Dialysis Bull 1981;1:S17-S19. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1982.00340230108019
Publisher site
See Article on Publisher Site

Abstract

Abstract In a population of 44 patients receiving continuous ambulatory peritoneal dialysis (CAPD) for a total of 591 patient months, there were 104 episodes of peritonitis. The organisms were gram-positive in 65.4%, gram-negative in 23.1%, and cultures of the dlalysate were sterile in 11.5%. Pseudomonas aeruginosa was the most frequently encountered gram-negative organism, accounting for 38.5% of the gram-negative infections or 9.6% of all infections. In all cases of P aeruginosa peritonitis, aminoglycoside antibiotic therapy for up to four weeks failed to eradicate the infection, and all patients required removal of the Tenckhoff catheter because of the presence of a sinus tract infection. We conclude that P aeruginosa is the most frequent cause of gram-negative peritonitis in patients receiving CAPD. The presence of a sinus tract infection should be suspected in all patients in whom peritonitis secondary to this organism develops. Removal of the Tenckhoff catheter will be required to cure the peritoneal infection. (Arch Intern Med 1982;142:1862-1863) References 1. Popovich RP, Moncrief JW, Dechard JB et al: The definition of a novel portable/wearable equilibrium peritoneal dialysis technique, abstracted. Am Soc Artif Intern Organs 1976;5:64. 2. Popovich RP, Moncrief JW, Nolph KD, et al: Continuous ambulatory peritoneal dialysis. Ann Intern Med 1978;88:449-456.Crossref 3. Oreopoulos DG, Robson M, Faller B, et al: Continuous peritoneal dialysis: A new era in the treatment of chronic renal failure. Clin Nephrol 1979;11:125-128. 4. Lacke C, Senekjian HO, Knight TF, et al: Twelve months' experience with continuous ambulatory and intermittent peritoneal dialysis. Arch Intern Med 1981;141:187-190.Crossref 5. Rubin J, Rogers WA, Taylor HM, et al: Peritonitis during continuous ambulatory peritoneal dialysis. Ann Intern Med 1980;92:7-13.Crossref 6. Faller B, Marichal JF: Treatment of chronic renal failure: Situation of CAPD. Int J Artif Organs 1980;3:243-244. 7. Nolph KD, Sorkin MI: Diagnosis and treatment of peritonitis , in Moncrief JW, Popovich RP (eds): CAPD Update . New York, Masson Publishing USA Inc, 1981, pp 265-272. 8. Vas S: Microbiological aspects of peritonitis. Peritoneal Dialysis Bull 1981;1:S11-S14. 9. Oreopoulos DG, Vas S, Khanna R: Treatment of peritonitis (in patients on CAPD) , in Moncrief JW, Popovich RP (eds): CAPD Update . New York, Masson Publishing USA Inc, 1981, pp 259-264. 10. Oreopoulos DG, Williams P, Khanna R, et al: Treatment of peritonitis. Peritoneal Dialysis Bull 1981;1:S17-S19.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Oct 1, 1982

References