title: Temporal trends in peritonitis rates, microbiology and outcomes: the major clinical complication of peritoneal dialysis.
abstract: Peritonitis remains a common complication of peritoneal dialysis (PD). The aim of this study was to analyze, in a PD center, long-term temporal trends in peritonitis rates, microbiology and outcomes. We treated 588 cases of peritonitis that occurred during 11,833.6 months at risk. Y-set and twin-bag disconnecting systems were introduced in 1990, mupirocin at the exit site in 2000 and fluconazole prophylaxis in 2005. Vancomycin and ceftazidime were the empiric protocol. Global and 5-year cohort rates were expressed as episodes/patient-year (ep/p-y). A global peritonitis rate reduction was found from 1.02 to 0.47 ep/p-y (p = 0.008). Poisson analyses performed in each of the subgroups of Gram-positive and Gram-negative peritonitis revealed no significant changes over time. No case of vancomycin resistance was identified. There was a downward trend in peritonitis-related hospitalization over time to 0.11 ep/p-y (p ≤ 0.001). Trend analysis showed a favorable, but changing evolution, highlighting the importance of accurate longitudinal PD center registry data and quality control.
authors.affiliation: Nephrology Department, CHP-Hospital Santo Antonio, Porto, Portugal. acrisbraga@gmail.com
authors.forename: Ana
authors.initials: A
authors.lastname: Rocha
authors.forename: Anabela
authors.initials: A
authors.lastname: Rodrigues
authors.forename: Laetitia
authors.initials: L
authors.lastname: Teixeira
authors.forename: Maria João
authors.initials: MJ
authors.lastname: Carvalho
authors.forename: Denisa
authors.initials: D
authors.lastname: Mendonça
authors.forename: António
authors.initials: A
authors.lastname: Cabrita
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use; D001419:Bacteria / Q000302:isolation & purification; D001424:Bacterial Infections / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D002442:Ceftazidime / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016712:Mupirocin / Q000627:therapeutic use; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology*; D016896:Treatment Outcome; D014640:Vancomycin / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D014640:Vancomycin; D015725:Fluconazole; D002442:Ceftazidime; D016712:Mupirocin