Clinical Characteristics of Enterococcus-Associated Peritonitis in Patients with Peritoneal Dialysis

Background: This study aims to investigate the clinical characteristics of enterococcus-associated peritonitis in patients with peritoneal dialysis (PD). Methods: In this retrospective study, patients with PD-associated enterococcal peritonitis (Group E) who were treated in our center between January 2010 and September 2020 were included. Patients with PD-associated streptococcus peritonitis (Group S) and patients with coagulase-negative staphylococcus peritonitis (Group CNS) were matched 1:1 as cohort-control groups. The clinical characteristics and prognosis of these patients were analyzed. Results: A total of 21 peritonitis episodes were noted in nine males and nine females, with an average age of 60.33 +/- 14.79 years and an average dialysis duration of 63.56 +/- 35.23 months. Mixed infection was observed in 7 out of 21 cases. A total of 22 strains of enterococci were identified in bacterial culture, all sensitive to vancomycin. There were significant differences in white blood cell (WBC) count and blood urea nitrogen (BUN) level among three groups on admission (p<0.05). In all three groups, WBC count on the second and third day post-treatment was higher in Group E than in other groups (p<0.05). The cure rate in Group E was lower than in other groups (p<0.01). The mortality rate in Group E was slightly higher than in other groups (p>0.05). Kaplan-Meier analysis revealed a significant difference in the cumulative survival among three groups (p<0.05). Conclusion: Enterococcus peritonitis is a rare and severe complication of peritoneal dialysis. Although vancomycin is effective for the treatment of Enterococcus infection, Enterococcus peritonitis still has a high rate of treatment failure, poor response to treatment, and poor prognosis as compared to CNS and streptococcus-related infections.