Changes in causative organisms and their antimicrobial susceptibilities in CAPD peritonitis: A single center's experience over one decade

Dong Ki Kim, Tae Hyun Yoo, Dong Ryeol Ryu, Zhong Gao Xu, Hyun Jin Kim, Kyu Hun Choi, Ho Yung Lee, Dae Suk Han, Shin Wook Kang

Research output: Contribution to journalReview article

115 Citations (Scopus)

Abstract

◆ Background: In recent years, the rate of peritonitis during continuous ambulatory peritoneal dialysis (CAPD) has been significantly reduced. However, peritonitis remains a major complication of CAPD, accounting for considerable mortality and hospitalization among CAPD patients. ◆ Objective: To generate a "center tailored" treatment protocol for CAPD peritonitis by examining the changes of causative organisms and their susceptibilities to antimicrobial agents over the past 10 years. ◆ Method: Retrospective review of the medical records of 1015 CAPD patients (1108 episodes of peritonitis) who were followed up from 1992 through 2001. ◆ Results: The overall incidence of peritonitis was 0.40 episodes/patient-year. The annual rate of peritonitis and the incidence of peritonitis caused by a single gram-positive organism were significantly higher in 1992 and 1993 compared with those in the rest of the years (p <0.05). The incidence of peritonitis due to coagulase-negative staphylococcus (CoNS) decreased significantly over time, whereas there was no significant change in the incidence of Staphylococcus aureus (SA)-induced peritonitis. Among CoNS, resistance to methicillin increased from 18.4% in 1992 - 1993 to 41.7% in 2000 - 2001 (p < 0.05). In contrast, the incidence of methicillin-resistant SA was not different according to the calendar year. Catheter removal rates were significantly higher in peritonitis due to a single gram-negative organism (16.6%) compared with gram-positive peritonitis (4.8%, p < 0.005). The mortality associated with peritonitis was also higher in gram-negative (3.7%) compared with gram-positive peritonitis (1.4%), but there was no statistical significance. Among single gram-positive organism-induced peritonitis, catheter removal rates were significantly higher in SA (9.3%) than those in CoNS (2.9%, p < 0.01) and other gram-positive organisms (2.9%, p < 0.05). In peritonitis caused by CoNS, the methicillin-resistant group showed significantly higher removal rates than the methicillin-susceptible group (8.2% vs 1.0%, p < 0.01). ◆ Conclusion: The incidence of peritonitis for 2001 decreased to less than half that for 1992, due mainly to a significant decrease in CoNS-induced peritonitis, whereas the proportions of peritonitis due to a single gram-negative organism and methicillin-resistant CoNS increased. These findings suggest that it is necessary to prepare new center-based guidelines for the initial empirical treatment of CAPD peritonitis.

Original languageEnglish
Pages (from-to)424-432
Number of pages9
JournalPeritoneal Dialysis International
Volume24
Issue number5
Publication statusPublished - 2004 Sep 1

Fingerprint

Continuous Ambulatory Peritoneal Dialysis
Peritonitis
Coagulase
Staphylococcus
Methicillin Resistance
Incidence
Staphylococcus aureus
Catheters
Methicillin
Mortality

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Kim, Dong Ki ; Yoo, Tae Hyun ; Ryu, Dong Ryeol ; Xu, Zhong Gao ; Kim, Hyun Jin ; Choi, Kyu Hun ; Lee, Ho Yung ; Han, Dae Suk ; Kang, Shin Wook. / Changes in causative organisms and their antimicrobial susceptibilities in CAPD peritonitis : A single center's experience over one decade. In: Peritoneal Dialysis International. 2004 ; Vol. 24, No. 5. pp. 424-432.
@article{13ea3cdfd5f24dbca96ffef90c69f5f2,
title = "Changes in causative organisms and their antimicrobial susceptibilities in CAPD peritonitis: A single center's experience over one decade",
abstract = "◆ Background: In recent years, the rate of peritonitis during continuous ambulatory peritoneal dialysis (CAPD) has been significantly reduced. However, peritonitis remains a major complication of CAPD, accounting for considerable mortality and hospitalization among CAPD patients. ◆ Objective: To generate a {"}center tailored{"} treatment protocol for CAPD peritonitis by examining the changes of causative organisms and their susceptibilities to antimicrobial agents over the past 10 years. ◆ Method: Retrospective review of the medical records of 1015 CAPD patients (1108 episodes of peritonitis) who were followed up from 1992 through 2001. ◆ Results: The overall incidence of peritonitis was 0.40 episodes/patient-year. The annual rate of peritonitis and the incidence of peritonitis caused by a single gram-positive organism were significantly higher in 1992 and 1993 compared with those in the rest of the years (p <0.05). The incidence of peritonitis due to coagulase-negative staphylococcus (CoNS) decreased significantly over time, whereas there was no significant change in the incidence of Staphylococcus aureus (SA)-induced peritonitis. Among CoNS, resistance to methicillin increased from 18.4{\%} in 1992 - 1993 to 41.7{\%} in 2000 - 2001 (p < 0.05). In contrast, the incidence of methicillin-resistant SA was not different according to the calendar year. Catheter removal rates were significantly higher in peritonitis due to a single gram-negative organism (16.6{\%}) compared with gram-positive peritonitis (4.8{\%}, p < 0.005). The mortality associated with peritonitis was also higher in gram-negative (3.7{\%}) compared with gram-positive peritonitis (1.4{\%}), but there was no statistical significance. Among single gram-positive organism-induced peritonitis, catheter removal rates were significantly higher in SA (9.3{\%}) than those in CoNS (2.9{\%}, p < 0.01) and other gram-positive organisms (2.9{\%}, p < 0.05). In peritonitis caused by CoNS, the methicillin-resistant group showed significantly higher removal rates than the methicillin-susceptible group (8.2{\%} vs 1.0{\%}, p < 0.01). ◆ Conclusion: The incidence of peritonitis for 2001 decreased to less than half that for 1992, due mainly to a significant decrease in CoNS-induced peritonitis, whereas the proportions of peritonitis due to a single gram-negative organism and methicillin-resistant CoNS increased. These findings suggest that it is necessary to prepare new center-based guidelines for the initial empirical treatment of CAPD peritonitis.",
author = "Kim, {Dong Ki} and Yoo, {Tae Hyun} and Ryu, {Dong Ryeol} and Xu, {Zhong Gao} and Kim, {Hyun Jin} and Choi, {Kyu Hun} and Lee, {Ho Yung} and Han, {Dae Suk} and Kang, {Shin Wook}",
year = "2004",
month = "9",
day = "1",
language = "English",
volume = "24",
pages = "424--432",
journal = "Peritoneal Dialysis International",
issn = "0896-8608",
publisher = "Multimed Inc.",
number = "5",

}

Changes in causative organisms and their antimicrobial susceptibilities in CAPD peritonitis : A single center's experience over one decade. / Kim, Dong Ki; Yoo, Tae Hyun; Ryu, Dong Ryeol; Xu, Zhong Gao; Kim, Hyun Jin; Choi, Kyu Hun; Lee, Ho Yung; Han, Dae Suk; Kang, Shin Wook.

In: Peritoneal Dialysis International, Vol. 24, No. 5, 01.09.2004, p. 424-432.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Changes in causative organisms and their antimicrobial susceptibilities in CAPD peritonitis

T2 - A single center's experience over one decade

AU - Kim, Dong Ki

AU - Yoo, Tae Hyun

AU - Ryu, Dong Ryeol

AU - Xu, Zhong Gao

AU - Kim, Hyun Jin

AU - Choi, Kyu Hun

AU - Lee, Ho Yung

AU - Han, Dae Suk

AU - Kang, Shin Wook

PY - 2004/9/1

Y1 - 2004/9/1

N2 - ◆ Background: In recent years, the rate of peritonitis during continuous ambulatory peritoneal dialysis (CAPD) has been significantly reduced. However, peritonitis remains a major complication of CAPD, accounting for considerable mortality and hospitalization among CAPD patients. ◆ Objective: To generate a "center tailored" treatment protocol for CAPD peritonitis by examining the changes of causative organisms and their susceptibilities to antimicrobial agents over the past 10 years. ◆ Method: Retrospective review of the medical records of 1015 CAPD patients (1108 episodes of peritonitis) who were followed up from 1992 through 2001. ◆ Results: The overall incidence of peritonitis was 0.40 episodes/patient-year. The annual rate of peritonitis and the incidence of peritonitis caused by a single gram-positive organism were significantly higher in 1992 and 1993 compared with those in the rest of the years (p <0.05). The incidence of peritonitis due to coagulase-negative staphylococcus (CoNS) decreased significantly over time, whereas there was no significant change in the incidence of Staphylococcus aureus (SA)-induced peritonitis. Among CoNS, resistance to methicillin increased from 18.4% in 1992 - 1993 to 41.7% in 2000 - 2001 (p < 0.05). In contrast, the incidence of methicillin-resistant SA was not different according to the calendar year. Catheter removal rates were significantly higher in peritonitis due to a single gram-negative organism (16.6%) compared with gram-positive peritonitis (4.8%, p < 0.005). The mortality associated with peritonitis was also higher in gram-negative (3.7%) compared with gram-positive peritonitis (1.4%), but there was no statistical significance. Among single gram-positive organism-induced peritonitis, catheter removal rates were significantly higher in SA (9.3%) than those in CoNS (2.9%, p < 0.01) and other gram-positive organisms (2.9%, p < 0.05). In peritonitis caused by CoNS, the methicillin-resistant group showed significantly higher removal rates than the methicillin-susceptible group (8.2% vs 1.0%, p < 0.01). ◆ Conclusion: The incidence of peritonitis for 2001 decreased to less than half that for 1992, due mainly to a significant decrease in CoNS-induced peritonitis, whereas the proportions of peritonitis due to a single gram-negative organism and methicillin-resistant CoNS increased. These findings suggest that it is necessary to prepare new center-based guidelines for the initial empirical treatment of CAPD peritonitis.

AB - ◆ Background: In recent years, the rate of peritonitis during continuous ambulatory peritoneal dialysis (CAPD) has been significantly reduced. However, peritonitis remains a major complication of CAPD, accounting for considerable mortality and hospitalization among CAPD patients. ◆ Objective: To generate a "center tailored" treatment protocol for CAPD peritonitis by examining the changes of causative organisms and their susceptibilities to antimicrobial agents over the past 10 years. ◆ Method: Retrospective review of the medical records of 1015 CAPD patients (1108 episodes of peritonitis) who were followed up from 1992 through 2001. ◆ Results: The overall incidence of peritonitis was 0.40 episodes/patient-year. The annual rate of peritonitis and the incidence of peritonitis caused by a single gram-positive organism were significantly higher in 1992 and 1993 compared with those in the rest of the years (p <0.05). The incidence of peritonitis due to coagulase-negative staphylococcus (CoNS) decreased significantly over time, whereas there was no significant change in the incidence of Staphylococcus aureus (SA)-induced peritonitis. Among CoNS, resistance to methicillin increased from 18.4% in 1992 - 1993 to 41.7% in 2000 - 2001 (p < 0.05). In contrast, the incidence of methicillin-resistant SA was not different according to the calendar year. Catheter removal rates were significantly higher in peritonitis due to a single gram-negative organism (16.6%) compared with gram-positive peritonitis (4.8%, p < 0.005). The mortality associated with peritonitis was also higher in gram-negative (3.7%) compared with gram-positive peritonitis (1.4%), but there was no statistical significance. Among single gram-positive organism-induced peritonitis, catheter removal rates were significantly higher in SA (9.3%) than those in CoNS (2.9%, p < 0.01) and other gram-positive organisms (2.9%, p < 0.05). In peritonitis caused by CoNS, the methicillin-resistant group showed significantly higher removal rates than the methicillin-susceptible group (8.2% vs 1.0%, p < 0.01). ◆ Conclusion: The incidence of peritonitis for 2001 decreased to less than half that for 1992, due mainly to a significant decrease in CoNS-induced peritonitis, whereas the proportions of peritonitis due to a single gram-negative organism and methicillin-resistant CoNS increased. These findings suggest that it is necessary to prepare new center-based guidelines for the initial empirical treatment of CAPD peritonitis.

UR - http://www.scopus.com/inward/record.url?scp=7444235485&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=7444235485&partnerID=8YFLogxK

M3 - Review article

C2 - 15490981

AN - SCOPUS:7444235485

VL - 24

SP - 424

EP - 432

JO - Peritoneal Dialysis International

JF - Peritoneal Dialysis International

SN - 0896-8608

IS - 5

ER -