title: Peritonitis in children with automated peritoneal dialysis: a single-center study of a 10-year experience.
abstract: Peritoneal dialysis (PD) constitutes the preferred dialysis modality for children requiring renal replacement therapy with peritonitis being one of the most common complications of PD. This study was performed to evaluate the epidemiology, microbiology, and outcomes of PD-associated peritonitis in Greek children for a 10-year period. A total of 27 patients (16 males) with a mean age 121.8 ± 57.2 months were retrospective analyzed. Patients were on PD therapy for a mean duration of 45.2 ± 26.1 months. We found 23 episodes of PD-associated peritonitis occurred in 9 out of 27 patients (0.23 episodes/patient-year), with four patients experienced two or more peritonitis episodes. Gram-positive bacteria were responsible for 15 (65.2%) peritonitis episodes, with Staphylococcus aureus being the predominant specie isolated in 30.4% of cases. A total of seven episodes of exit-site infections (ESIs) were identified in five patients (0.069 episodes/patient-year) with the most common bacteria isolated being S. aureus (57.4%). Initial antibiotic treatment included intraperitoneal vancomycin plus ceftazidime in the majority of cases (82.6%). At the end of study, 12 (44.4%) patients remained on PD, 11 (41.8%) underwent renal transplantation, 2 (7.4%) shifted to hemodialysis and unfortunately, two patients (7.4%) died. Conclusively, our study revealed a noticeable low peritonitis and ESIs rate as compared to international data and represents the first evaluation of the characteristics and outcomes of peritonitis in the Greek pediatric PD population.
authors.affiliation: a 1st Department of Pediatrics , Hippokration Hospital, Aristotle University of Thessaloniki , Thessaloniki , Greece ;
authors.forename: John
authors.initials: J
authors.lastname: Dotis
authors.affiliation: b Medical School, Aristotle University of Thessaloniki , Thessaloniki , Greece.
authors.forename: Pavlos
authors.initials: P
authors.lastname: Myserlis
authors.affiliation: a 1st Department of Pediatrics , Hippokration Hospital, Aristotle University of Thessaloniki , Thessaloniki , Greece ;
authors.forename: Nikoleta
authors.initials: N
authors.lastname: Printza
authors.affiliation: a 1st Department of Pediatrics , Hippokration Hospital, Aristotle University of Thessaloniki , Thessaloniki , Greece ;
authors.forename: Stella
authors.initials: S
authors.lastname: Stabouli
authors.affiliation: a 1st Department of Pediatrics , Hippokration Hospital, Aristotle University of Thessaloniki , Thessaloniki , Greece ;
authors.forename: Chrysa
authors.initials: C
authors.lastname: Gkogka
authors.affiliation: a 1st Department of Pediatrics , Hippokration Hospital, Aristotle University of Thessaloniki , Thessaloniki , Greece ;
authors.forename: Antigoni
authors.initials: A
authors.lastname: Pavlaki
authors.affiliation: a 1st Department of Pediatrics , Hippokration Hospital, Aristotle University of Thessaloniki , Thessaloniki , Greece ;
authors.forename: Fotios
authors.initials: F
authors.lastname: Papachristou
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002442:Ceftazidime / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007274:Injections, Intraperitoneal; D007676:Kidney Failure, Chronic / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010538:Peritonitis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin; D002442:Ceftazidime
keywords: Exit-site infections; Greek children; intraperitoneal therapy; peritoneal dialysis; peritonitis