The Effect of Culture Technique on Culture Positivity in Peritoneal Dialysis Patients with Peritonitis

Objective: We aimed to analyze all peritonitis attacks recorded in our unit, and examine the correlation between culturing technique and culture positivity.Methods: The files of 103 patients have been examined retrospectively. Clinical findings, cell counts of the peritoneal fluid, microorganisms isolated, treatment protocols and the outcome were recorded. Peritonitis attacks before and after 2008 were compared in terms of culture positivity. Results: During the follow-up of 103 patients (mean treatment duration 23.79 ± 18.23 months) for 2450.72 patient-months, 80 peritonitis attacks were recorded. The number of attacks per patient was 0.78, and one attack occurred every 30.63 patient-months. Culture positivity before and after 2008 were 39.21% and 55.17%, respectively (p<0.001).Conclusions: Culture negativity, reported to be up to 20%, decreases the effectiveness of treatment, increases the incidence of autotoxicity, and loss of residual renal function due to antibiotics, results in secondari fungal peritonitis attacks and emergence of vancomycin-resistant enterococci. Inappropriate culture technique and recent antibiotic use were leading causes of culture negativity. Prevention of inappropriate antibiotic use and improving culture techniques, as in our study, may increase culture positivity.