title: A single-centre experience: peritoneal dialysis-related infections in patients on long-term dialysis.
abstract: OBJECTIVE
  Peritoneal dialysis is a convenient way of maintaining patients with end stage renal disease (ESRD) and in the present days, the Thai government supports all payments for ESRD patients. Continuous ambulatory peritoneal dialysis-(CAPD) related infections are the major cause of morbidity and mortality. The present study was conducted to identify the incidence and epidemiological data of CAPD-related infection.
  
  
  METHODS
  Medical records of 333 CAPD patients attending the Dialysis Unit of Phramongkutklao Hospital from January 1983 to June 2007 were reviewed. The historical cohort study was focused on the incidence of CAPD-related infections, causing pathogens, risk factors, and patient outcome.
  
  
  RESULTS
  In total, 73.3% of episodes developed peritoneal infection. The incidences of peritonitis, exit site infection, and tunnel infection were 0.864, 0.213, and 0.034 episodes per patient per year, respectively. The most common infecting organisms were gram positive cocci (49.1%). The main pathogens were Coagulase-negative staphylococcus (15.9%), Staphylococcus aureus (15.2%) and Pseudomonas spp. (14.2%). CAPD-related infections increased in patients who had age > 60. A total of 81% of the infections responded to initial antibiotic therapy administered in the dialysis fluid. Overall, there were 10 episodes (1.9%) of the refractory group and 83 episodes (15.4%) of peritoneal catheter loss, with an overall mortality rate of 1.1%. Non-vancomycin based regimens were applied in 63.9% of peritoneal infected patients.
  
  
  CONCLUSIONS
  The authors' center's CAPD-related infection rate achieved the International Society for Peritoneal Dialysis (ISPD) recommendation. A significantly enhanced incidence of CAPD-related infection occurred in advanced age. Coagulase-negative staphylococcus is still a very common organism that generally responds well to antibiotic therapy.
authors: Department of Clinical Tropical Medicine, Faculty of Tropical, Mahidol Univesity, Bangkok, Thailand.
authors: Viravarn
authors: V
authors: Luvira
authors: Bancha
authors: B
authors: Satirapoj
authors: Ouppatham
authors: O
authors: Supasyndh
authors: Amnart
authors: A
authors: Chaiprasert
authors: Prajej
authors: P
authors: Ruangkanchanasetr
authors: Naowanit
authors: N
authors: Nata
authors: Inseey
authors: I
authors: Kanjanakul
authors: Thanom
authors: T
authors: Supaporn
authors: Panbuppa
authors: P
authors: Choovichian
authors: Sutachard
authors: S
authors: Bijaphala
authors: Usana
authors: U
authors: Luvira
authors: Danabhand
authors: D
authors: Phiboonbanakit
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002408:Catheters, Indwelling / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010538:Peritonitis / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents