Daniela Ponce1, Thyago Proença de Moraes2, Roberto Pecoits-Filho2, Ana Elizabeth Figueiredo3, Pasqual Barretti1. 1. Department of Medicine, São Paulo State University (UNESP), Botucatu, Brazil. 2. Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil. 3. Programa de Pós-Graduação em Medicina e Ciências da Saúde (Nefrologia), Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
Abstract
BACKGROUND: We performed this study to evaluate the incidence, risk factors, microbiology, treatment, and outcome of peritonitis in pediatric Peritoneal dialysis (PD) patients at a nationwide prospective study. METHODOLOGY: Patients younger than 18 years recruited in the BRAZPD II study from 2004 to 2011, who presented their first peritonitis episode, were included in the study. RESULTS: We found 125 first episodes of peritonitis in 491 children PD patients (0.43 episodes/patient-year). Patients free of peritonitis episode constituted 75.6% in 1 year. Culture-negative episodes were very high (59.2%) and gram-positive (GP) bacteria were the most commonly found organisms (58.8%). First-generation cephalosporin was the initial choice to cover GP (40.5%) and aminoglycosides was the most prescribed antibiotics used for gram-negative agents (27.5%). Treatment failure was 26.4%. Technique failure (TF) occurred in 12.1% and peritonitis was the main cause (65.1%). Pseudomonas (p = 0.04) and negative cultures (p < 0.001) were identified as predictors of TF. CONCLUSION: Peritonitis remains a common complication of PD in children and negative cultures and pseudomonas had a negative impact on TF.
BACKGROUND: We performed this study to evaluate the incidence, risk factors, microbiology, treatment, and outcome of peritonitis in pediatric Peritoneal dialysis (PD) patients at a nationwide prospective study. METHODOLOGY:Patients younger than 18 years recruited in the BRAZPD II study from 2004 to 2011, who presented their first peritonitis episode, were included in the study. RESULTS: We found 125 first episodes of peritonitis in 491 childrenPDpatients (0.43 episodes/patient-year). Patients free of peritonitis episode constituted 75.6% in 1 year. Culture-negative episodes were very high (59.2%) and gram-positive (GP) bacteria were the most commonly found organisms (58.8%). First-generation cephalosporin was the initial choice to cover GP (40.5%) and aminoglycosides was the most prescribed antibiotics used for gram-negative agents (27.5%). Treatment failure was 26.4%. Technique failure (TF) occurred in 12.1% and peritonitis was the main cause (65.1%). Pseudomonas (p = 0.04) and negative cultures (p < 0.001) were identified as predictors of TF. CONCLUSION:Peritonitis remains a common complication of PD in children and negative cultures and pseudomonas had a negative impact on TF.
Authors: Saeed M AlZabli; Mohammed A Alsuhaibani; Meshail A BinThunian; Dayel A Alshahrani; Abdulkarim Al Anazi; Sibi Varghese; Vernice Rose; Khawla A Rahim Journal: Int J Pediatr Adolesc Med Date: 2020-09-19
Authors: Scott F Pangonis; Joshua K Schaffzin; Donna Claes; Joel E Mortenson; Edward Nehus Journal: Pediatr Nephrol Date: 2022-04-20 Impact factor: 3.651