title: [Peritonitis in pediatric patients receiving peritoneal dialysis].
abstract: BACKGROUND
  Peritonitis on catheter of dialysis represents the most frequent complication of the peritoneal dialysis (PD) in the pediatric population. It remains a significant cause of morbidity and mortality. In this study, we investigated the risk factors for peritonitis in children.
  
  
  METHODS
  In this study, we retrospectively collected the records of 85 patients who were treated with PD within the past ten years in the service of pediatrics of the University Hospital Charles-Nicolle of Tunis.
  
  
  RESULTS
  Peritonitis rate was 0.75 episode per patient-year. Notably, peritonitis caused by Gram-positive organisms were more common. Analysis of infection risk revealed three significant independent factors: the poor weight (P=0.0045), the non-automated PD (P=0.02) and the short delay from catheter insertion to starting PD (P=0.02). The early onset peritonitis was significantly associated with frequent peritonitis episodes (P=0.0008). The mean duration between the first and second episode of peritonitis was significantly shorter than between PD commencement and the first episode of peritonitis. We revealed a significant association between Gram-negative peritonitis and the presence of ureterostomy (0.018) and between Gram-positive peritonitis and the presence of exit-site and tunnel infections (0.02). Transition to permanent hemodialysis was needed in many children but no death occurred in patients with peritonitis.
  
  
  CONCLUSIONS
  Considering the important incidence of peritonitis in our patients, it is imperative to establish a targeted primary prevention. Nutritional care must be provided to children to avoid poor weight. The automated dialysis has to be the modality of choice.
authors.affiliation: Service de pédiatrie, hôpital Charles-Nicolles, Tunis, Tunisie. Electronic address: maneljellouli@yahoo.fr.
authors.forename: Manel
authors.initials: M
authors.lastname: Jellouli
authors.affiliation: Service de pédiatrie, hôpital Charles-Nicolles, Tunis, Tunisie.
authors.forename: Meriem
authors.initials: M
authors.lastname: Ferjani
authors.affiliation: Service de pédiatrie, hôpital Charles-Nicolles, Tunis, Tunisie.
authors.forename: Kamel
authors.initials: K
authors.lastname: Abidi
authors.affiliation: Service de pédiatrie, hôpital Charles-Nicolles, Tunis, Tunisie.
authors.forename: Yosra
authors.initials: Y
authors.lastname: Hammi
authors.affiliation: Service de bactériologie, hôpital Charles-Nicolles, Tunis, Tunisie.
authors.forename: Ilhem
authors.initials: I
authors.lastname: Boutiba
authors.affiliation: Service de pédiatrie, hôpital Charles-Nicolles, Tunis, Tunisie.
authors.forename: Ouns
authors.initials: O
authors.lastname: Naija
authors.affiliation: Service de pédiatrie, hôpital Charles-Nicolles, Tunis, Tunisie.
authors.forename: Chokri
authors.initials: C
authors.lastname: Zarrouk
authors.affiliation: Service de médecine interne et de néphrologie, hôpital Charles-Nicolles, Tunis, Tunisie.
authors.forename: Taieb
authors.initials: T
authors.lastname: Ben Abdallah
authors.affiliation: Service de pédiatrie, hôpital Charles-Nicolles, Tunis, Tunisie.
authors.forename: Tahar
authors.initials: T
authors.lastname: Gargah
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D010372:Pediatrics; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014416:Tunisia; D055815:Young Adult
keywords: Children; Dialyse péritonéale; Enfant; Facteurs de risque; Peritoneal dialysis; Peritonitis; Péritonite; Risk factors