title: Peritoneal dialysis-associated peritonitis with simultaneous exit-site infection.
abstract: With the implementation of best demonstrated clinical practices, peritonitis has become an infrequent complication of peritoneal dialysis in many centers around the world. Yet the gains in reduction in risk of peritonitis are not uniform. Most episodes of peritonitis do not require hospitalization and it is possible to achieve cure rates of 70%-80%. Some circumstances, however, necessitate the removal of the peritoneal dialysis catheter. These include patients with inadequate response to antimicrobial therapy, those with fungal peritonitis, or those with Staphylococcus aureus or Pseudomonas peritonitis with coexisting exit-site infection with the same organism. If the peritoneal dialysis catheter is removed in the presence of active intraperitoneal infection, replacement of the peritoneal dialysis catheter should be deferred by 2-4 weeks. However, simultaneous removal and replacement is possible in selected circumstances such as in patients with S. aureus or Pseudomonas peritonitis who also have exit-site infection with the same organism, after the intraperitoneal infection has responded to antibiotic therapy.
authors.affiliation: Department of Medicine, Harborview Medical Center, University of Washington, 325 Ninth Avenue, Seattle, WA 98104, USA. rmehrotr@uw.edu
authors.forename: Rajnish
authors.initials: R
authors.lastname: Mehrotra
authors.forename: Harmanjit
authors.initials: H
authors.lastname: Singh
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D020878:Device Removal / Q000009:adverse effects / Q000379:methods; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003928:Diabetic Nephropathies / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000379:methods; D010538:Peritonitis / Q000188:drug therapy* / Q000382:microbiology*; D011552:Pseudomonas Infections / Q000188:drug therapy; D013203:Staphylococcal Infections / Q000188:drug therapy; D013211:Staphylococcus aureus / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents