Fungal peritonitis in peritoneal dialysis patients: effect of fluconazole treatment and use of the twin-bag disconnect system.
Fungal peritonitis is an uncommon but potentially life-threatening complication for patients undergoing continuous ambulatory peritoneal dialysis. This retrospective study evaluated the efficacy of fluconazole in fungal peritonitis treatment and the incidence of fungal peritonitis in different peritoneal dialysis disconnect systems. Fungal peritonitis was caused by Candida species in 67% of episodes. The most common pathogen in this series was Candida parapsilosis (29%), followed by Candida albicans (14%). One patient (5%) died within 1 month after admission for treatment of fungal peritonitis. Only 1 patient (5%) in this series could resume peritoneal dialysis. Treatment with fluconazole alone has an effect comparable to intraperitoneal (IP) amphotericin B alone or IP amphotericin B combined with oral or intravenous fluconazole. The incidence of fungal peritonitis in patients who used the spike, Y-set, and UV antiseptic systems was 5.69, 6.20, and 2.93 times, respectively, as frequent as that of fungal peritonitis in patients who used the twin-bag disconnect system.
Chen
Chih-Ming
CM
Division of Infectious Disease, Department of Internal Medicine, China Medical University Hospital, No. 2 Yuh Der Road, Taichung, Taiwan 404, ROC.
Ho
Mao-Wang
MW
Yu
Wen-Liang
WL
Wang
Jen-Hsien
JH
D000293:Adolescent; D000328:Adult; D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002175:Candida / Q000145:classification / Q000302:isolation & purification*; D004359:Drug Therapy, Combination; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology*; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D012189:Retrospective Studies; D016896:Treatment Outcome
D000935:Antifungal Agents; D000666:Amphotericin B; D015725:Fluconazole