title: Outcomes of peritonitis in children on peritoneal dialysis: a 25-year experience at Severance Hospital.
abstract: OBJECTIVE
  Relatively little is known on the microbiology, risk factors and outcomes of peritoneal dialysis (PD)-associated peritonitis in Korean children. We performed this study in order to evaluate the incidence, treatment and clinical outcomes of peritonitis in pediatric PD patients at Severance Hospital.
  
  
  METHODS
  We analyzed data from 57 PD patients younger than 18 years during the period between June 1, 1986 and December 31, 2011. The collected data included gender, age at commencement of PD, age at peritonitis, incidence of peritonitis, underlying causes of end stage renal disease, microbiology of peritonitis episodes, antibiotics sensitivity, modality and outcomes of PD.
  
  
  RESULTS
  We found 56 episodes of peritonitis in 23 of the 57 PD patients (0.43 episodes/patient-year). Gram-positive bacteria were the most commonly isolated organisms (40 episodes, 71.4%). Peritonitis developed in 17 patients during the first 6 months following initiation of PD (73.9%). Peritonitis episodes rarely resulted in relapse or the need for permanent hemodialysis and no patient deaths were directly attributable to peritonitis. Antibiotic regimens included cefazolin+tobramycin from the years of 1986 to 2000 and cefazolin+ ceftazidime from the years of 2001 to 2011. While antibiotic therapy was successful in 48 episodes (85.7%), the treatment was ineffective in 8 episodes (14.3%). The rate of continuous ambulatory PD (CAPD) peritonitis was statistically higher than that of automated PD (APD) (p=0.025).
  
  
  CONCLUSIONS
  Peritonitis was an important complication of PD therapy and we observed a higher incidence of PD peritonitis in patients with CAPD when compared to APD.
authors.affiliation: Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
authors.forename: Kyong Ok
authors.initials: KO
authors.lastname: Lee
authors.forename: Se Jin
authors.initials: SJ
authors.lastname: Park
authors.forename: Ji Hong
authors.initials: JH
authors.lastname: Kim
authors.forename: Jae Seung
authors.initials: JS
authors.lastname: Lee
authors.forename: Pyung Kil
authors.initials: PK
authors.lastname: Kim
authors.forename: Jae Il
authors.initials: JI
authors.lastname: Shin
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002437:Cefazolin / Q000627:therapeutic use; D002442:Ceftazidime / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000379:methods; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010538:Peritonitis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology*; D014031:Tobramycin / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002442:Ceftazidime; D002437:Cefazolin; D014031:Tobramycin
keywords: Peritoneal dialysis; automated peritoneal dialysis; children; continuous ambulatory peritoneal dialysis; peritonitis