All Title Author
Keywords Abstract


Is the Distribution of Microorganisms and Peritonitis Affected by Seasonality in Peritoneal Dialysis?

DOI: 10.4236/ojneph.2014.44021, PP. 146-151

Keywords: Chronic Renal Insufficiency, Peritoneal Dialysis, Peritonitis, Seasonal Variations

Full-Text   Cite this paper   Add to My Lib

Abstract:

Introduction: Peritonitis continues to be the main complication for patients on peritoneal dialysis (PD). Objective: To determine the frequency of peritonitis according to the disease-causing microorganism and its distribution throughout the year, linking to seasonality. Methods: A retrospective study conducted in the Dialysis Unit of the Hospital São Lucas, PUCRS (HSL-PUCRS). Patients undergoing PD between January 1984 and September 2013 were included. Descriptive statistics were used and Fisher’s exact test with Monte Carlo simulation for comparison between the categorical variables. Results: Of 415 evaluated patients, 66% had at least one episode of peritonitis with an incidence rate of 0.68 episode/year. There were 601 peritonitis episodes in total. The most common microorganism was coagulase-negative Staphylococcus (26.6%, n = 160), followed by Staphylococcus aureus (16.3%, n = 98), with 16.3% of the sample being negative culture. Most episodes occurred in the months of January (10.3%, n = 62) and May (10.1%, n = 61), while June had the lowest occurrence (5.2%, n = 31). The number of episodes observed in January and May were significantly higher when compared to June (p < 0.001). No significant differences were found for the remaining months. There was no association between the microorganisms and months of the year (p = 0.841). Conclusion: The rate of peritonitis is in line with that recommended by the International Society for Peritoneal Dialysis. The distribution of peritonitis-causing germs over the months of the year would seem to be random.

References

[1]  Cho, Y. and Johnson, D.W. (2014) Peritoneal Dialysis-Related Peritonitis: Towards Improving Evidence, Practices, and Outcomes. American Journal of Kidney Diseases: The Official Journal of the National Kidney Foundation, 64, 278-289. http://dx.doi.org/10.1053/j.ajkd.2014.02.025
[2]  Chaudhary, K. (2011) Peritoneal Dialysis Drop-Out: Causes and Prevention Strategies. International Journal of Nephrology, 2011, Article ID: 434608. http://dx.doi.org/10.4061/2011/434608
[3]  Bender, F.H., Bernardini, J. and Piraino, B. (2006) Prevention of Infectious Complications in Peritoneal Dialysis: Best Demonstrated Practices. Kidney International Supplement, 70, S44-S54. http://dx.doi.org/10.1038/sj.ki.5001915
[4]  Figueiredo, A.E., Poli de Figueiredo, C.E. and d’Avila, D.O. (2000) Peritonitis Prevention in CAPD: To Mask or Not? Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, 20, 354-358.
[5]  Wong, C., Luk, I.W., Ip, M. and You, J.H. (2014) Prevention of Gram-Positive Infections in Peritoneal Dialysis Patients in Hong Kong: A Cost-Effectiveness Analysis. American Journal of Infection Control, 42, 412-416.
http://dx.doi.org/10.1016/j.ajic.2013.12.008
[6]  Barretti, P., Moraes, T.M., Camargo, C.H., Caramori, J.C., Mondelli, A.L., Montelli, A.C., et al. (2012) Peritoneal Dialysis-Related Peritonitis Due to Staphylococcus aureus: A Single-Center Experience over 15 Years. PloS ONE, 7, e31780. http://dx.doi.org/10.1371/journal.pone.0031780
[7]  Figueiredo, A.E., Poli de Figueiredo, C.E. and d’Avila, D.O. (2001) Bag Exchange in Continuous Ambulatory Peritoneal Dialysis without Use of a Face Mask: Experience of Five Years. Advances in Peritoneal Dialysis Conferenceon Peritoneal Dialysis, 17, 98-100.
[8]  Figueiredo, A.E., Poli-de-Figueiredo, C.E., Meneghetti, F., Lise, G.A., Detofoli, C.C. and Silva, L.B. (2013) Peritonitis in Patients on Peritoneal Dialysis: Analysis of a Single Brazilian Center Based on the International Society for Peritoneal Dialysis. Jornal brasileiro de nefrologia: Orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia, 35, 214-219. http://dx.doi.org/10.5935/0101-2800.20130034
[9]  Johnson, D.W., Clark, C., Isbel, N.M., Hawley, C.M., Beller, E., Cass, A., et al. (2009) The Honeypot Study Protocol: A Randomized Controlled Trial of Exit-Site Application of Medihoney Antibacterial Wound Gel for the Prevention of Catheter-Associated Infections in Peritoneal Dialysis Patients. Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, 29, 303-309.
[10]  Al-Hwiesh, A.K. and Abdul Rahman, I.S. (2008) Prevention of Staphylococcal Peritonitis in CAPD Patients Combining Ablution and Mupirocin. Saudi Journal of Kidney Diseases and Transplantation: An Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 19, 737-745.
[11]  Nessim, S.J., Komenda, P., Rigatto, C., Verrelli, M. and Sood, M.M. (2013) Frequency and Microbiology of Peritonitis and Exit-Site Infection among Obese Peritoneal Dialysis Patients. Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, 33, 167-174. http://dx.doi.org/10.3747/pdi.2011.00244
[12]  Nouwen, J.L., Fieren, M.W., Snijders, S., Verbrugh, H.A. and van Belkum, A. (2005) Persistent (Not Intermittent) Nasal Carriage of Staphylococcus aureus is the Determinant of CPD-Related Infections. Kidney International, 67, 1084-1092. http://dx.doi.org/10.1111/j.1523-1755.2005.00174.x
[13]  Moraes, T.P., Pecoits-Filho, R., Ribeiro, S.C., Rigo, M., Silva, M.M., Teixeira, P.S., Pasqual, D.D., Fuerbringer, R. and Riella, M.C. (2009) Peritoneal Dialysis in Brazil: Twenty-Five Years of Experience in a Single Center. Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, 29, 492-498.
[14]  Li, P.K., Szeto, C.C., Piraino, B., Bernardini, J., Figueiredo, A.E., Gupta, A., et al. (2010) Peritoneal Dialysis-Related Infections Recommendations: 2010 Update. Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, 30, 393-423. http://dx.doi.org/10.3747/pdi.2010.00049
[15]  Sesso Rde, C., Lopes, A.A., Thome, F.S., Lugon, J.R., Watanabe, Y. and Santos, D.R. (2012) Chronic Dialysis in Brazil: Report of the Brazilian Dialysis Census, 2011. Jornal brasileiro de nefrologia: Orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia, 34, 272-277. http://dx.doi.org/10.5935/0101-2800.20120009
[16]  Cho, Y., Badve, S.V., Hawley, C.M., McDonald, S.P., Brown, F.G., Boudville, N., et al. (2012) Seasonal Variation in Peritoneal Dialysis-Associated Peritonitis: A Multi-Centre Registry Study. Nephrology, Dialysis, Transplantation: Official Publication of the European Dialysis and Transplant Association—European Renal Association, 27, 2028-2036.
http://dx.doi.org/10.1093/ndt/gfr582
[17]  Kim, M.J., Song, J.H., Park, Y.J., Kim, G.A. and Lee, S.W. (2000) The Influence of Seasonal Factors on the Incidence of Peritonitis in Continuous Ambulatory Peritoneal Dialysis in the Temperate Zone. Advances in Peritoneal Dialysis Conference on Peritoneal Dialysis, 16, 243-247.
[18]  Dos Santos, R.P., Konkewicz, L.R., Nagel, F.M., Lisboa, T., Xavier, R.C., Jacoby, T., et al. (2013) Changes in Hand Hygiene Compliance after a Multimodal Intervention and Seasonality Variation. American Journal of Infection Control, 41, 1012-1016. http://dx.doi.org/10.1016/j.ajic.2013.05.020
[19]  Szeto, C.C., Chow, K.M., Wong, T.Y., Leung, C.B. and Li, P.K. (2003) Influence of Climate on the Incidence of Peritoneal Dialysis-Related Peritonitis. Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, 23, 580-586.
[20]  Lok, C.E., Thumma, J.R., McCullough, K.P., Gillespie, B.W., Fluck, R.J., Marshall, M.R., et al. (2014) Catheter-Related Infection and Septicemia: Impact of Seasonality and Modifiable Practices from the DOPPS. Seminars in Dialysis, 27, 72-77. http://dx.doi.org/10.1111/sdi.12141
[21]  Bernardini, J., Price, V. and Figueiredo, A. (2006) Peritoneal Dialysis Patient Training. Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, 26, 625-632.

Full-Text

comments powered by Disqus