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. 2011 Apr;6(4):827-33.
doi: 10.2215/CJN.05370610. Epub 2010 Dec 23.

Repeat peritonitis in peritoneal dialysis: retrospective review of 181 consecutive cases

Cheuk-Chun Szeto  1 , Bonnie Ching-Ha Kwan, Kai-Ming Chow, Man-Ching Law, Wing-Fai Pang, Chi-Bon Leung, Philip Kam-Tao Li
Affiliations

Repeat peritonitis in peritoneal dialysis: retrospective review of 181 consecutive cases

Cheuk-Chun Szeto et al. Clin J Am Soc Nephrol. 2011 Apr.

Abstract

Background and objectives: The clinical behavior of repeat-peritonitis episodes, defined as peritonitis with the same organism occurring more than 4 weeks after completion of therapy for a prior episode, is poorly understood.

Design, setting, participants, & measurements: We compared outcomes of 181 episodes of repeat peritonitis from 1995 to 2009 (Repeat Group) with 91 episodes of relapsing peritonitis (Relapsing Group) and 125 episodes of peritonitis preceded 4 weeks or longer by another episode with a different organism (Control Group).

Results: In Repeat Group, 24% were due to Staphylococcus aureus, as compared with 5.5% in Relapsing Group and 15% in Control Group. The majority of the organisms causing relapsing peritonitis were Gram negative (62%), whereas the majority of that in Repeat Group were Gram positive (56%). Repeat Group had a lower complete-cure rate (70.7% versus 54.9%) than Relapsing Group, but rates of primary response, catheter removal, and mortality were similar. Repeat Group had a higher primary response rate (89.0% versus 73.6%) and a lower rate of catheter removal (6.1% versus 15.2%) than Control Group, whereas the complete-cure rate and mortality were similar. Repeat Group had a higher risk of developing relapsing (14.3% versus 2.2%) and repeat peritonitis (26.1% versus 5.4%) than Control Group, whereas the risk of recurrent peritonitis was similar.

Conclusions: Repeat peritonitis is a distinct clinical entity. Although repeat-peritonitis episodes generally have a satisfactory response to antibiotic, they have a substantial risk of developing further relapsing or repeat peritonitis.

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Figures

Figure 1.
Figure 1.
Summary of clinical outcome. (A) Repeat Group. (B) Relapsing Group. (C) Control Group.
See this image and copyright information in PMC

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