Continuous ambulatory peritoneal dialysis: evaluation of three new culture methods.
Out of 900 dialysates analysed over 15 months at the Rennes Regional Hospital, 116 cloudy specimens with a leucocyte count of more than 100/mm3 were studied. Three methods of laboratory diagnosis based on physical or chemical disruption of leucocytes were evaluated: saponin incorporated in the agar medium, sonication, and the Isolator lysis centrifugation system. Sensitivity was improved (52%) for the three methods combined compared with the standard method (37%). The Isolator system (51%, P < 0.05) gave the best results. Direct microscopic examination nevertheless remains essential for its indicative value (sensitivity 33% of positive dialysates). The leucocyte count was correlated with the percentage of culture positivity (43% from 100-200/mm3 compared with 62% from 500-1000/mm3); 80% of organisms were Gram-positive bacteria and most were coagulase-negative staphylococci. Opportunistic pathogens such as Corynebacterium jeikeium were frequently isolated.
Mesnard
R
R
Laboratoire de bactériologie-virologie, Hôpital de Pontchaillou, Rennes, France.
Corvisier
J M
JM
Sire
J M
JM
Pouëdras
P
P
Donnio
P Y
PY
Avril
J L
JL
D003354:Corynebacterium Infections / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology; D005602:France; D006801:Humans; D007958:Leukocyte Count; D008828:Microbiological Techniques; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010538:Peritonitis / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000209:etiology / Q000382:microbiology