title: The changing profile of PD-related peritonitis in Thailand: a single centers experience.
abstract: OBJECTIVE
  The percentage of utilizing peritoneal dialysis (PD) in Thailand was increased dramatically since the implementation of PD-First policy in 2008. However, peritonitis remains a major obstacle to achieve success of this modality. The aim of the present study, was to assess the clinical characteristics of PD peritonitis in the PD-first policy era.
  
  
  METHODS
  The PD peritonitis patients in Bhumibol Adulyadej Hospital between October 2008 and December 2010 were reviewed. Microbiological diagnosis, treatment responses, technique, and patient survival were analyzed.
  
  
  RESULTS
  Since October 2008, 93 peritoneal dialysis patients were followed-up in Bhumibol Adulyadej Hospital including 75 new cases. During the present study period of 1,560 patient-months, 51 episodes of peritonitis from 33 cases were recorded and analyzed. The mean age of the peritonitis patients was 57.9 +/- 16.1 years and 63.6% were females. The most common isolates were gram negative organisms (33.3%) followed by gram positive (17.6%) and fungi (5.9%). Nocardiosis was diagnosed in 1 patient. However, 43.1% of episodes were culture-negative peritonitis. Treatment of peritonitis resulted in a complete cure in 74.5% of patients while 7.8% of patients required catheter removal, and 17.6% died. Event-free survival was better in gram positive organisms (43.3 months) compared with those infected with gram negative (26.8 months) and culture negative peritonitis (16.1 months).
  
  
  CONCLUSIONS
  The proportions of peritonitis due to gram negative organisms were increased and associated with less favorable outcome. These findings suggest that it is necessary to prepare the appropriate protocol for prevention and treatment of PD peritonitis under national PD-First policy scheme.
authors: Division of Nephrology, Department of Medicine, Bhumibol Adulyadej Hospital, Bangkok, Thailand. pnopnit@hotmail.com
authors: Noppanit
authors: N
authors: Pattanachaiwit
authors: Pongsathorn
authors: P
authors: Gojaseni
authors: Jukrit
authors: J
authors: Junrak
authors: Pattaya
authors: P
authors: Riengchan
authors: Thaweepong
authors: T
authors: Pajareya
authors: Anutra
authors: A
authors: Chittinandana
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D012189:Retrospective Studies; D017678:Sex Distribution; D013785:Thailand / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents