Peritonitis in children with automated peritoneal dialysis: a single-center study of a 10-year experience

Ren Fail. 2016 Aug;38(7):1031-5. doi: 10.1080/0886022X.2016.1183256. Epub 2016 May 17.

Abstract

Peritoneal dialysis (PD) constitutes the preferred dialysis modality for children requiring renal replacement therapy with peritonitis being one of the most common complications of PD. This study was performed to evaluate the epidemiology, microbiology, and outcomes of PD-associated peritonitis in Greek children for a 10-year period. A total of 27 patients (16 males) with a mean age 121.8 ± 57.2 months were retrospective analyzed. Patients were on PD therapy for a mean duration of 45.2 ± 26.1 months. We found 23 episodes of PD-associated peritonitis occurred in 9 out of 27 patients (0.23 episodes/patient-year), with four patients experienced two or more peritonitis episodes. Gram-positive bacteria were responsible for 15 (65.2%) peritonitis episodes, with Staphylococcus aureus being the predominant specie isolated in 30.4% of cases. A total of seven episodes of exit-site infections (ESIs) were identified in five patients (0.069 episodes/patient-year) with the most common bacteria isolated being S. aureus (57.4%). Initial antibiotic treatment included intraperitoneal vancomycin plus ceftazidime in the majority of cases (82.6%). At the end of study, 12 (44.4%) patients remained on PD, 11 (41.8%) underwent renal transplantation, 2 (7.4%) shifted to hemodialysis and unfortunately, two patients (7.4%) died. Conclusively, our study revealed a noticeable low peritonitis and ESIs rate as compared to international data and represents the first evaluation of the characteristics and outcomes of peritonitis in the Greek pediatric PD population.

Keywords: Exit-site infections; Greek children; intraperitoneal therapy; peritoneal dialysis; peritonitis.

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Ceftazidime / administration & dosage
  • Ceftazidime / therapeutic use
  • Child
  • Child, Preschool
  • Female
  • Greece / epidemiology
  • Humans
  • Incidence
  • Infant
  • Injections, Intraperitoneal
  • Kidney Failure, Chronic / drug therapy
  • Kidney Failure, Chronic / therapy*
  • Male
  • Peritoneal Dialysis / adverse effects*
  • Peritonitis / drug therapy
  • Peritonitis / epidemiology*
  • Peritonitis / microbiology*
  • Retrospective Studies
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / etiology
  • Staphylococcus aureus / isolation & purification
  • Treatment Outcome
  • Vancomycin / administration & dosage
  • Vancomycin / therapeutic use
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Vancomycin
  • Ceftazidime