Chia-Ter Chao1, Szu-Ying Lee2, Wei-Shun Yang3, Huei-Wen Chen4, Cheng-Chung Fang5, Chung-Jen Yen6, Chih-Kang Chiang4, Kuan-Yu Hung4, Jenq-Wen Huang4. 1. Department of Traumatology, National Taiwan University Hospital, Taipei, Taiwan Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. 2. Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin County, Taiwan. 3. Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu County, Taiwan. 4. Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. 5. Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan. 6. Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan.
Abstract
BACKGROUND: The clinical courses and long-term outcomes of viridans streptococcus (VS) peritoneal dialysis (PD) peritonitis remain unclear. METHODS: We conducted a retrospective analysis of all PD patients in a single center with gram-positive cocci (GPC) peritonitis between 2005 and 2011, and divided them into 3 groups: VS, other streptococci and other GPC (apart from VS). Clinical characteristics and outcomes of the VS group were compared with the other streptococci and other GPC groups, with prognostic factors determined. RESULTS: A total of 140 patients with 168 episodes of GPC peritonitis (44% of all peritonitis) were identified over 7 years. Among these, 18 patients (13%) developed VS peritonitis, while 14 patients (10%) developed other streptococcal peritonitis. Patients with VS peritonitis had a high cure rate by antibiotic alone (94%), despite a high polymicrobial yield frequency (28%). We found that VS peritonitis carried a lower risk of Tenckhoff catheter removal and relapsing episodes than other GPC peritonitis (6% vs 11%), and a lower mortality than other streptococci peritonitis (0% vs 7%). However, after the index peritonitis episodes, VS, other streptococci, and other GPC group had a significantly increased peritonitis incidence compared with the period before the index peritonitis (all p < 0.01). Patients with VS peritonitis had a significantly higher incidence of refractory peritonitis compared with other streptococci or other GPC peritonitis in the long term (both p < 0.01). CONCLUSIONS: VS poses a higher risk of subsequent refractory peritonitis after the index episode as compared with other streptococcal or GPC peritonitis. It might be prudent to monitor the technique of these patients with VS peritonitis closely to avoid further peritonitis episodes.
BACKGROUND: The clinical courses and long-term outcomes of viridans streptococcus (VS) peritoneal dialysis (PD) peritonitis remain unclear. METHODS: We conducted a retrospective analysis of all PDpatients in a single center with gram-positive cocci (GPC) peritonitis between 2005 and 2011, and divided them into 3 groups: VS, other streptococci and other GPC (apart from VS). Clinical characteristics and outcomes of the VS group were compared with the other streptococci and other GPC groups, with prognostic factors determined. RESULTS: A total of 140 patients with 168 episodes of GPC peritonitis (44% of all peritonitis) were identified over 7 years. Among these, 18 patients (13%) developed VS peritonitis, while 14 patients (10%) developed other streptococcal peritonitis. Patients with VS peritonitis had a high cure rate by antibiotic alone (94%), despite a high polymicrobial yield frequency (28%). We found that VS peritonitis carried a lower risk of Tenckhoff catheter removal and relapsing episodes than other GPC peritonitis (6% vs 11%), and a lower mortality than other streptococci peritonitis (0% vs 7%). However, after the index peritonitis episodes, VS, other streptococci, and other GPC group had a significantly increased peritonitis incidence compared with the period before the index peritonitis (all p < 0.01). Patients with VS peritonitis had a significantly higher incidence of refractory peritonitis compared with other streptococci or other GPC peritonitis in the long term (both p < 0.01). CONCLUSIONS: VS poses a higher risk of subsequent refractory peritonitis after the index episode as compared with other streptococcal or GPC peritonitis. It might be prudent to monitor the technique of these patients with VS peritonitis closely to avoid further peritonitis episodes.
Authors: W F Keane; G R Bailie; E Boeschoten; R Gokal; T A Golper; C J Holmes; Y Kawaguchi; B Piraino; M Riella; S Vas Journal: Perit Dial Int Date: 2000 Jul-Aug Impact factor: 1.756
Authors: Edwina A Brown; Simon J Davies; Peter Rutherford; Frederique Meeus; Mercedes Borras; Werner Riegel; Jose C Divino Filho; Edward Vonesh; Monique van Bree Journal: J Am Soc Nephrol Date: 2003-11 Impact factor: 10.121
Authors: Philip Kam-Tao Li; Cheuk Chun Szeto; Beth Piraino; Javier de Arteaga; Stanley Fan; Ana E Figueiredo; Douglas N Fish; Eric Goffin; Yong-Lim Kim; William Salzer; Dirk G Struijk; Isaac Teitelbaum; David W Johnson Journal: Perit Dial Int Date: 2016-06-09 Impact factor: 1.756