title: Microbiological Trends and Antimicrobial Resistance in Peritoneal Dialysis-Related Peritonitis, 2005 to 2014.
abstract: ♦ BACKGROUND: Information related to the microbiology of peritonitis is critical to the optimal management of patients receiving peritoneal dialysis (PD). The goal was to characterize the microbiological etiology and antimicrobial susceptibilities of PD-related peritonitis (PDRP) from 2005 to 2014, inclusive. ♦ METHODS: The distribution of organisms in culture-positive PDRP was described for new episodes and relapse infections, and further detailed for monomicrobial and polymicrobial peritonitis. Annual and overall rates of PDRP were also characterized. Antimicrobial susceptibility rates were calculated for the most common and significant organisms. ♦ RESULTS: We identified 539 episodes of PDRP including 501 new and 38 relapse infections. New episodes of peritonitis were associated with a single organism in 85% of cases, and 44% of those involved staphylococci. Polymicrobial PDRP was more likely to involve gram-negative organisms, observed in 58% versus 24% of monomicrobial infections. Antimicrobial resistance was relatively stable from 2005 to 2014. Methicillin resistance was present in 57% ofStaphylococcus epidermidisand 20% of other coagulase-negative staphylococci. Methicillin-resistantStaphylococcus aureus(MRSA) accounted for only 11% ofS. aureusperitonitis compared with 2% in our previous study of PDRP from 1991 to 1998. Ciprofloxacin resistance inEscherichia coliincreased from 3% in our previous study to 24% in 2005 - 2014. ♦ CONCLUSIONS: This study characterizes important differences in the distribution of organisms in new episodes of PDRP and relapse infections, as well as monomicrobial versus polymicrobial peritonitis. It also shows relatively stable rates of antimicrobial resistance from 2005 to 2014, but some increases compared with our previous study.
authors.affiliation: College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada zelenits@umanitoba.ca.|St. Boniface Hospital, Winnipeg, Manitoba, Canada.
authors.forename: Sheryl A
authors.initials: SA
authors.lastname: Zelenitsky
authors.affiliation: College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Jacy
authors.initials: J
authors.lastname: Howarth
authors.affiliation: Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.|St. Boniface Hospital, Winnipeg, Manitoba, Canada.
authors.forename: Philippe
authors.initials: P
authors.lastname: Lagacé-Wiens
authors.affiliation: Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.|St. Boniface Hospital, Winnipeg, Manitoba, Canada.|Manitoba Renal Program, Manitoba, Canada.
authors.forename: Christie
authors.initials: C
authors.lastname: Sathianathan
authors.affiliation: College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.|St. Boniface Hospital, Winnipeg, Manitoba, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Ariano
authors.affiliation: College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.|St. Boniface Hospital, Winnipeg, Manitoba, Canada.|Manitoba Renal Program, Manitoba, Canada.
authors.forename: Christine
authors.initials: C
authors.lastname: Davis
authors.affiliation: Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.|St. Boniface Hospital, Winnipeg, Manitoba, Canada.|Manitoba Renal Program, Manitoba, Canada.
authors.forename: Mauro
authors.initials: M
authors.lastname: Verrelli
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002170:Canada; D016208:Databases, Factual; D004352:Drug Resistance, Microbial; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects* / Q000379:methods; D010538:Peritonitis / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D013212:Staphylococcus epidermidis / Q000187:drug effects / Q000302:isolation & purification; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Infection; antimicrobial resistance; microbiology; relapse; staphylococcus