Microbiology, Clinical Spectrum and Outcome of Peritonitis in Patients Undergoing Peritoneal Dialysis in India: Results from a Multicentric, Observational Study

被引:10
作者
Abraham, Georgi [1 ]
Gupta, Amit [9 ]
Prasad, Kashi Nath [10 ]
Rohit, Anusha [2 ]
Bhalla, Anil Kumar [11 ]
Billa, Vishwanath [12 ]
Chakravati, Rajasekhar [14 ]
Das, Tonmoy [15 ]
Dhinakaran, Thadakanathan [5 ,6 ]
Dutta, Arup Ratan [16 ,17 ]
Giri, Padmanabhan [8 ]
Gokulnath [18 ]
Jeloka, Tarun [13 ]
Kumar, Sampath [7 ]
Marwaha, Ajay [19 ]
Raghavan, Radha Vijay [3 ]
Ravichandran, Rajan [4 ]
Rohit, Roshan [21 ]
Sarkar, Chandra Nath [16 ,17 ]
Singh, Naorem Sharat Kumar [20 ]
机构
[1] Madras Med Mission, Dept Nephrol, Madras, Tamil Nadu, India
[2] Madras Med Mission, Dept Microbiol, Madras, Tamil Nadu, India
[3] Southern Railway Hosp, Dept Nephrol, Madras, Tamil Nadu, India
[4] MIOT Int, Dept Nephrol, Madras, Tamil Nadu, India
[5] Madurai Kidney Ctr, Dept Nephrol, Madurai, Tamil Nadu, India
[6] Transplantat Res Ctr, Madurai, Tamil Nadu, India
[7] Meenakshi Mission Hosp & Res Ctr, Dept Nephrol, Madurai, Tamil Nadu, India
[8] Renal Care Hosp, Dept Nephrol, Tiruchirappalli, Tamil Nadu, India
[9] Sanjay Gandhi Postgrad Inst Med Sci, Dept Nephrol, Lucknow, Uttar Pradesh, India
[10] Sanjay Gandhi Postgrad Inst Med Sci, Dept Microbiol, Lucknow, Uttar Pradesh, India
[11] Sir Gangaram Hosp, Dept Nephrol, New Delhi, India
[12] Apcx Kidney Care, Dept Nephrol, Bombay, Maharashtra, India
[13] Aditya Birla Mem Hosp, Dept Nephrol, Pune, Maharashtra, India
[14] Care Hosp, Dept Nephrol, Hyderabad, Telangana, India
[15] Int Hosp, Dept Nephrol, Gauhati, Assam, India
[16] Fortis Hosp, Dept Nephrol, Kolkata, W Bengal, India
[17] Kidney Inst, Kolkata, W Bengal, India
[18] St Johns Med Coll Hosp, Dept Nephrol, Bengaluru, Karnataka, India
[19] Kidney Hosp, Dept Nephrol, Jalandhar, Punjab, India
[20] Reg Inst Med Sci, Dept Nephrol, Imphal, Manipur, India
[21] Baxter India Pvt Ltd, Dept Med Res & Med Affairs Ind, Hyderabad, Andhra Pradesh, India
关键词
Causative organisms; peritonitis; seasonal variation; CAPD PERITONITIS; INFECTION; ORGANISMS; THERAPY;
D O I
10.4103/ijmm.IJMM_17_392
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background: Peritoneal dialysis (PD)-related peritonitis is a major risk factor for drop out of patients on continuous ambulatory PD (CAPD) and automated PD (APD). Factors affecting PD-related peritonitis and centre-specific microbiological data are lacking in India. A multicentric prospective observational study was designed to overcome the gaps in the existing data regarding causative organism and outcome. Methodology: The present study was a prospective, uncontrolled, open-label; observational study conducted in 21 centres representing all the four geographical regions (North, South, East and West) of India between April 2010 and December 2011. Results: A total of 244 patients on chronic PD with peritonitis were enrolled in the study (CAPD and APD), who met the inclusion criteria, from 21 centres covering the different geographical areas of India. Amongst the 85 samples that were culture positive, 38 (44.7%) were in the monsoon season followed by 23 (27.1%) in the post-monsoon, 18 (21.2%) during winter and 11 (12.9%) during summer. Maximum culture positivity (72.7%) was observed with automated culture technique. Microorganisms could be isolated in only 85 cases (35.3%) while the remaining samples were culture negative (156/241, 64.7% of samples). Organisms isolated were Gram-negative in 47.8%, Gram-positive in 36.7%, fungal in 13.3% and Mycobacterium tuberculosis in 2.2%. Conclusion: This large multicentre study of peritonitis offers insights into the aetiology and outcomes of infectious complications of chronic PD in India that are germane to clinical decision-making.
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页码:491 / 498
页数:8
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