title: Ten-year experience with fungal peritonitis in peritoneal dialysis patients: antifungal susceptibility patterns in a North-American center.
abstract: OBJECTIVE
  To describe the clinical and microbiological features associated with fungal peritonitis in peritoneal dialysis (PD) patients at Hôpital Maisonneuve-Rosemont, from August 1996 to July 2006.
  
  
  METHODS
  Cases were retrieved from the microbiology laboratory culture registry. Antifungal susceptibility was determined by the Clinical and Laboratory Standards Institute M27A3 method.
  
  
  RESULTS
  Among 288 PD patients (total follow-up of 7258 patient-months), nine were found with fungal peritonitis. Candida spp were identified in all of them, with a majority of non-albicans Candida species. Resistance to fluconazole, itraconazole, or voriconazole was as frequent as potential resistance to amphotericin B. No isolate was resistant to caspofungin and one was resistant to micafungin. Prior bacterial peritonitis was frequent (67%). All patients had their PD catheter removed and all of them survived.
  
  
  CONCLUSIONS
  In our institution, fungal peritonitis in PD patients is rare. All cases were caused by Candida species. Variable susceptibility patterns were observed, which may influence the initial empirical antifungal therapy and underscore the importance of individual speciation and susceptibility testing of invasive Candida isolates.
authors: Service de Néphrologie, Hôpital Maisonneuve-Rosemont, Université de Montréal, 5415 Blvd de l'Assomption, Montréal, Qc, H1T 2M4 Canada.
authors: Jasmin
authors: J
authors: Levallois
authors: Annie-Claire
authors: AC
authors: Nadeau-Fredette
authors: Annie-Claude
authors: AC
authors: Labbé
authors: Michel
authors: M
authors: Laverdière
authors: Denis
authors: D
authors: Ouimet
authors: Michel
authors: M
authors: Vallée
mesh_terms: D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D002175:Candida / Q000302:isolation & purification / Q000472:pathogenicity; D000077336:Caspofungin; D025141:Drug Resistance, Fungal; D054714:Echinocandins / Q000627:therapeutic use; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D055666:Lipopeptides / Q000627:therapeutic use; D008297:Male; D000077551:Micafungin; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D009656:North America / Q000453:epidemiology; D010530:Peritoneal Dialysis / Q000379:methods*; D010538:Peritonitis / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D011743:Pyrimidines / Q000627:therapeutic use; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D011743:Pyrimidines; D014230:Triazoles; D017964:Itraconazole; D000666:Amphotericin B; D015725:Fluconazole; D000077336:Caspofungin; D065819:Voriconazole; D000077551:Micafungin