title: Coagulase negative staphylococcal peritonitis in peritoneal dialysis patients: review of 232 consecutive cases.
abstract: OBJECTIVE
  Coagulase-negative Staphylococcus species is the most common cause of peritoneal dialysis-related peritonitis; however, the optimal treatment strategy of coagulase-negative Staphylococcus species peritonitis remains controversial.
  
  
  METHODS
  All of the coagulase-negative Staphylococcus species peritonitis in a dialysis unit from 1995 to 2006 were reviewed. During this period, there were 2037 episodes of peritonitis recorded; 232 episodes (11.4%) in 155 patients were caused by coagulase-negative Staphylococcus species.
  
  
  RESULTS
  The overall primary response rate was 95.3%; the complete cure rate was 71.1%. Patients with a history of recent hospitalization or recent antibiotic therapy had a higher risk for developing methicillin-resistant strains. Episodes that were treated initially with cefazolin or vancomycin had similar primary response rate and complete cure rate. There were 33 (14.2%) episodes of relapse and 29 (12.5%) episodes of repeat peritonitis; 12 (60.6%) of the repeat episodes developed within 3 mo after completion of antibiotics. Relapse or repeat episodes had a significantly lower complete cure rate than the other episodes. For relapse or repeat episodes, treatment with effective antibiotics for 3 wk was associated with a significantly higher complete cure rate than the conventional 2-wk treatment.
  
  
  CONCLUSIONS
  Coagulase-negative Staphylococcus species peritonitis remains a common complication of peritoneal dialysis. Methicillin resistance is common, but the treatment outcome remains favorable when cefazolin is used as the first-line antibiotic. A 3-wk course of antibiotic can probably achieve a higher cure rate in relapse or repeat episodes.
authors.affiliation: Department of Medicine & Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong, China. ccszeto@cuhk.edu.hk
authors.forename: Cheuk-Chun
authors.initials: CC
authors.lastname: Szeto
authors.forename: Bonnie Ching-Ha
authors.initials: BC
authors.lastname: Kwan
authors.forename: Kai-Ming
authors.initials: KM
authors.lastname: Chow
authors.forename: Miu-Fong
authors.initials: MF
authors.lastname: Lau
authors.forename: Man-Ching
authors.initials: MC
authors.lastname: Law
authors.forename: Kwok-Yi
authors.initials: KY
authors.lastname: Chung
authors.forename: Chi-Bon
authors.initials: CB
authors.lastname: Leung
authors.forename: Philip Kam-Tao
authors.initials: PK
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002437:Cefazolin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D010530:Peritoneal Dialysis; D010538:Peritonitis / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D012307:Risk Factors; D055502:Secondary Prevention; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin; D002437:Cefazolin