Fungal peritonitis in patients on continuous ambulatory peritoneal dialysis: a single centre Indian experience.
BACKGROUND
Fungal peritonitis (FP) is a serious complication in patients on continuous ambulatory peritoneal dialysis (CAPD). We reviewed our FP cases to analyse the causative agents and possible risk factors in relation to FP and its outcome and mortality.


METHODS
Records of all FP cases were reviewed. FP was diagnosed based on effluent cell count and positive fungal culture in suitable media.


RESULTS
Between October 1993 and November 2001, 261 patients underwent CAPD. FP was detected in 28 patients, one episode in each patient (14.3% of the total peritonitis episodes). Candida species and dematiaceous fungi+/-Candida species were responsible for 89.3 and 10.7% of episodes, respectively. Patients with preceding bacterial peritonitis (BP) developed FP more frequently (25.6%) than de novo cases (2.9%) (P<0.0001) and lower proportion of them continued CAPD (8.6% vs. 60%; P=0.007). Mortality in patients having abdominal pain with and without fever, and catheter in situ was significantly higher than in those patients who did not have these risk factors (9/11 vs. 6/17, P=0.01; 13/17 vs. 2/11, P=0.003; 6/6, vs. 9/22, P=0.01, respectively).


CONCLUSIONS
Higher proportion of our patients had FP; preceding BP was a significant risk factor for development of FP and technique failure. Abdominal pain+/-fever in patients and catheter in situ were identified as risk factors associated with mortality.
Prasad
K N
KN
Department of Microbiology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow, India. knprasad@sgpgi.ac.in
Prasad
N
N
Gupta
A
A
Sharma
R K
RK
Verma
A K
AK
Ayyagari
A
A
D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000453:epidemiology / Q000209:etiology*; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010538:Peritonitis / Q000453:epidemiology / Q000382:microbiology*; D012189:Retrospective Studies; D012307:Risk Factors