Outcome Following CAPD-Associated Gram-Negative Peritonitis

腹膜透析併發格蘭氏陰性菌腹膜炎之預後分析

陳嘉聖(Chia-Sheng Chen) ； 鐘錫裕(Shyi-Yu Chung) ； 余文良(Wen-Liang Yu) ； 高銘聰(Ming-Tzung Kao)

《Acta Nephrologica》 15卷2期 (2001/04) Pp. 66-70

摘要

Peritonitis remains the leading cause of patient dropout from peritoneal dialysis therapy. Gram-positive [G(+)] bacteria predominate among the pathogens causing continuous ambulatory peritoneal dialysis (CAPD)-associated peritonitis. Gram-negative [G(-)] peritonitis has a poor outcome. Few studies have compared the outcomes for different kinds of G (-) peritonitis in patients undergoing CAPD. This study compared morbidity, mortality and outcomes for peritonitis caused by common G (-) bacilli, including Escherichia coli (E.coli), Klebsiella pneumoniae (K. pneumoniae), Pseudomonas aeruginosa (P. aeruginosa), and Enterobacter spp. A retrospective review study was designed for a single regional dialysis unit in a medical center. Between January 1, 1998 and December 31,2000, a total of 220 episodes of CAPD-associated peritonitis were recorded in 120 patients, with 45 of these episodes caused by G (-) organisms. Survival analysis was performed for time to (1) death, (2) removal of the peritoneal dialysis catheter and (3) changing to hemodialysis. Demographic data, hospital admission, laboratory values, infection type and route of antibiotic administration were also recorded and analyzed. There were no differences in age, sex, diabetes mellitus (DM), hospital admission, positive blood cultures, infection type or the antibiotic administration route among the four etiologic groups. Of note, serum albumin was higher in the E. coli group than in the other groups (p＜0.05). No differences in time to death, removal of the peritoneal dialysis catheter, or change to hemodialysis were demonstrated among the four groups (p=0.48). Results indicate that the outcomes for peritonitis caused by E. coli, K. pneumoniae, P. aeruginosa and Enterobacter spp do not differ significantly. Further observations and an increased sample size may confirm this finding.

關鍵字

腹膜透析 ； 格欄氏陰性菌腹膜炎

並列摘要

Peritonitis remains the leading cause of patient dropout from peritoneal dialysis therapy. Gram-positive [G(+)] bacteria predominate among the pathogens causing continuous ambulatory peritoneal dialysis (CAPD)-associated peritonitis. Gram-negative [G(-)] peritonitis has a poor outcome. Few studies have compared the outcomes for different kinds of G (-) peritonitis in patients undergoing CAPD. This study compared morbidity, mortality and outcomes for peritonitis caused by common G (-) bacilli, including Escherichia coli (E.coli), Klebsiella pneumoniae (K. pneumoniae), Pseudomonas aeruginosa (P. aeruginosa), and Enterobacter spp. A retrospective review study was designed for a single regional dialysis unit in a medical center. Between January 1, 1998 and December 31,2000, a total of 220 episodes of CAPD-associated peritonitis were recorded in 120 patients, with 45 of these episodes caused by G (-) organisms. Survival analysis was performed for time to (1) death, (2) removal of the peritoneal dialysis catheter and (3) changing to hemodialysis. Demographic data, hospital admission, laboratory values, infection type and route of antibiotic administration were also recorded and analyzed. There were no differences in age, sex, diabetes mellitus (DM), hospital admission, positive blood cultures, infection type or the antibiotic administration route among the four etiologic groups. Of note, serum albumin was higher in the E. coli group than in the other groups (p＜0.05). No differences in time to death, removal of the peritoneal dialysis catheter, or change to hemodialysis were demonstrated among the four groups (p=0.48). Results indicate that the outcomes for peritonitis caused by E. coli, K. pneumoniae, P. aeruginosa and Enterobacter spp do not differ significantly. Further observations and an increased sample size may confirm this finding.

並列關鍵字

continuous ambulatory peritonedl dialysis, Gram-negative peritonitis, outcome