Effect of Seasonal Changes on Incidence of Continuous Ambulatory Peritoneal Dialysis Peritonitis-Analysis from Weather Parameters and Microbial Etiology

季節的轉變影響腹膜透析腹膜炎的發生率－以氣候因子及微生物培養的結果來分析

吳建興(Chien-Hsing Wu) ； 廖上智(Shang-Chih Liao) ； 李建德(Chien-Te Lee) ； 荘峰榮(Feng-Rong Chuang) ； 陳靖博(Jin-Bor Chen) ； 許國泰(Kuo-Tai Hsu) ； 簡玉樹(Yu-Shu Chien) ； 李志雄(Chih-Hsiung Lee) ； 鄭本忠(Ben-Chung Cheng) ； 劉建秀(Chien-Hsiu Liu)

《Acta Nephrologica》 23卷1期 (2009/03) Pp. 26-32

並列摘要

Background: The influence of weather cur continuous ambulatory peritoneal dialysis (CAPD) peritonitis is controversial. Several published studies have not been able to demonstrate a definite relationship between changes in weather and the occurrence of CAPD peritonitis. Na studies have urns far investigated the relationship between seasonal changes and CAPD peritonitis in Taiwan.
Method: We reviewed retrospectively CAPD peritonitis treated at our peritoneal dialysis (PD) unit front January 1997 to December 2007. To assess whether changes in seasons have impact an rite raze of CAPD peritonitis, we collected the monthly peritonitis rate throughout the period of study, microbiologic etiology of each peritonitis episode, the average monthly peritonitis rate throughout the period of study, microbiologic etiology of each peritonitis episode, the average monthly temperature and monthly relative humidity when the peritonitis developed.
Results: There were 348 episodes of peritonitis recorded at our peritoneal dialysis center. There were two peaks of incidence rates of CAPD peritonitis: February and June. According to the General Linear Model analysis, seasonal changes, average monthly tempera fare and monthly relative humidity had statistically significant (p＜0.05) impact on monthly CAPD peritonitis rate. Two relevant and significantly increased incidence rates of CAPD peritonitis were identified during the entire study period: one is March to April (p=0.016) and the other is December to January (p=0.010). Staphylococcus aureus (SA) and S. epidermidis (SE) CAPD peritonitis episodes were predominantly more than non-SA and non-SE peritonitis in warmer: The number of culture-negative episodes tended to be higher than that of culture-positive episodes from December to January hue the difference wan net statistically significant (p=0.057).
Conclusion: We observed that seasonal change had statistically significant impact on incidence of CAPD peritonitis rate with the peak incidence in June and February. March to April and December to January were trio periods of relevant and significantly increased incidence rates of CAPD peritonitis. SA and SE were two prominent microbial etiologies in summer and there was a trend of more culture-negative peritonitis episodes or the early winter month of January. This finding can be employed to effectively predict the occurrence of CAPD peritonitis and educate patients to take appropriate precautions.

並列關鍵字

seasonal changes ； temperature ； humidity ； continuous ambulatory peritoneal dialysis CAPD peritonitis