The prevalence and bacterial distribution of peritonitis amongst adults undergoing continuous ambulatory peritoneal dialysis at Universitas hospital

Jolly Musoke; Feziwe Bisiwe; Akhil Natverlal; Ilyas Moola; Yusuf Moola; Umar Kajee; Antonio Parlato; Andrea Bailey; Jerome Arendse

doi:10.4102/sajid.v35i1.104

The prevalence and bacterial distribution of peritonitis amongst adults undergoing continuous ambulatory peritoneal dialysis at Universitas hospital

S Afr J Infect Dis. 2020 Mar 16;35(1):104. doi: 10.4102/sajid.v35i1.104. eCollection 2020.

Authors

Jolly Musoke¹, Feziwe Bisiwe², Akhil Natverlal³, Ilyas Moola³, Yusuf Moola³, Umar Kajee³, Antonio Parlato³, Andrea Bailey³, Jerome Arendse¹

Affiliations

¹ Department of Medical Microbiology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
² Department of Internal Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
³ Department of Biostatistics, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.

Abstract

Background: Peritonitis is the leading cause of morbidity and technique failure in peritoneal dialysis (PD) patients. The International Society for Peritoneal Dialysis (ISPD) recommends each centre to monitor the peritonitis rates and the causative organisms in order to guide local empiric antibiotic protocols. The aim of this study was to report on the peritonitis rates and describe the causative microorganisms and the antibiotic susceptibility in continuous ambulatory peritoneal dialysis (CAPD) adult patients at the Universitas Academic Hospital.

Methods: A single-centre, retrospective descriptive survey was conducted to determine the peritonitis rates in PD patients (January-December 2016). All CAPD patients aged ≥18 years, who presented with clinical features of PD-associated peritonitis, were included. The peritonitis episodes were studied per patient, and the causative microorganisms and the antibiotic susceptibility of the organisms were described.

Results: One hundred and twenty-eight patients underwent CAPD. The peritonitis rate was 1.45 episodes per year at risk. The prevalence of CAPD patients affected by at least one episode of CAPD-associated peritonitis during 2016 was 56.3%. The majority of episodes (76.7%) (n = 122) were mono-microbial. Gram-positive organisms accounted for 73.0% (n = 116) of the peritonitis episodes, coagulase-negative Staphylococcus being the most common. Gram-negative organisms accounted for 15.7% (n = 25) of the peritonitis episodes, and the common pathogens was Enterobacteriaceae.

Conclusion: The peritonitis rate was alarmingly high, with 1.45 episodes per year at risk; this is three times more than the recommended 0.5 episodes per year according to the ISPD guidelines. The culture-negative rate of 8.8% is within ISPD-acceptable limits. There is a need to strengthen preventive measures with regard to peritonitis.

Keywords: CAPD patients; Universitas Academic Hospital; bacterial distribution; peritoneal dialysis; peritonitis.