Peritonitis in patients on peritoneal dialysis: a 12-year experience from a large medical center in Bursa

Bülent Gül
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Abstract

Objectives: Despite all technical advances, Peritonitis remains the most important peritoneal dialysis (PD) complication. Peritonitis causes complications such as additional hospitalization, technical failure, peritoneal membrane damage, consequent transition to hemodialysis, and death in this patient group. Early diagnosis, isolation of the causative pathogen with appropriate methods as soon as possible, and determination of antibiotic susceptibilities play a crucial role in solving the problem of treating peritonitis in PD. This study evaluated the frequency of peritonitis, culture positivity rate, and prognosis in peritoneal dialysis patients in our unit for 12 years. Methods: A total of 171 patients (80 F, 91 M; mean age: 51.9±15.3 year; mean PD duration 36.5±36.4 months) who were followed up in our department between January 2009 and July 2021 were included in the study. Patient records were retrospectively analyzed. Results: Peritonitis never occurred in 105 of the 171 patients included in the study. Of the remaining 66 patients, 43 had one peritonitis attack, and 23 had more than two. The mean peritonitis rate was 1.68±1.36. One hundred eleven episodes of peritonitis were detected in 66 of the patients. Bacterial growth was observed in 63.06% of the culture samples obtained from the 93 peritonitis episodes. The peritoneal catheter was withdrawn in 14 (21.21%) cases. Conclusion: In our unit, the rate of culture positivity was 63.06%, and the peritonitis attack rate was 0.017 per patient-month and 0.211 per patient-year over a period of twelve years, with a mean of 57.1 patient months of peritonitis.
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腹膜透析患者的腹膜炎:布尔萨一家大型医疗中心的 12 年经验
目的:尽管技术不断进步,腹膜炎仍然是腹膜透析(PD)最重要的并发症。腹膜炎导致的并发症包括:住院时间延长、技术失败、腹膜损伤、转为血液透析,以及腹膜透析患者死亡。早期诊断、尽快用适当的方法分离致病病原体以及确定抗生素敏感性对解决腹膜透析患者腹膜炎的治疗问题起着至关重要的作用。本研究评估了我院腹膜透析患者 12 年来的腹膜炎发生率、培养阳性率和预后。研究方法研究纳入了 2009 年 1 月至 2021 年 7 月期间在我科随访的 171 例患者(80 例女性,91 例男性;平均年龄:51.9±15.3 岁;平均腹膜透析时间:36.5±36.4 个月)。对患者病历进行回顾性分析。 结果171例患者中有105例从未发生腹膜炎。在剩余的 66 名患者中,43 人发生过一次腹膜炎,23 人发生过两次以上腹膜炎。平均腹膜炎发生率为 1.68±1.36。在 66 名患者中,有 111 例腹膜炎发作。在 93 次腹膜炎中,63.06% 的培养样本中观察到细菌生长。有 14 例(21.21%)患者拔出了腹膜导管。结论在我们科室,培养阳性率为 63.06%,腹膜炎发作率为 0.017 次/月和 0.211 次/年,平均腹膜炎发作率为 57.1 次/月。
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