Peritonitis related to chronic peritoneal dialysis in Slovenian pediatric patients

Aims: Peritonitis is the most significant complication of chronic peritoneal dialysis (PD). We aimed to define the frequency and country-specific characteristics of peritonitis in Slovenian pediatric patients. Materials and methods: All 23 children and adolescents treated with PD at our center between November 1995 and December 2019 were included in the study. There were 15 boys (65.2%) and 8 girls (34.8%). The median age at PD start was 4.8 years (range: 0 - 16.8 years). Patient demographic data, PD modality, treatment duration, and PD-related infections were collected retrospectively by reviewing the patients' medical records and the microbiology database. Data on the number of peritonitis episodes, microbiology results, and treatment outcomes were of prime interest. Results: 30 peritonitis episodes were registered. The incidence rate was 1/33 patient-months (0.35/year). Twelve patients never experienced peritonitis (52.2%). Grampositive organisms were isolated in 52.9% (Staphylococcus aureus (4/18), Staphylococcus epidermidis (4/18)). Gram-negative isolates were present in 32.4% (Escherichia coli (4/11), Pseudomonas species (2/11)). Fungal peritonitis occurred in 2.9% and negative culture peritonitis in 11.8%. Initial empirical treatment with vancomycin and ceftazidime was successful in 89.5%. PD was discontinued in 2 patients (8.7%) because of fungal peritonitis and refractory peritonitis. Conclusion: Our results compare favorably with the published literature. Awareness of local patient and microbial characteristics is crucial for the successful treatment and prevention of PD-associated infections.