Rates of peritoneal dialysis -associated peritonitis and causative organisms at the Baskent University Hospital from 2000 to 2006

Peritoneal dialysis is an important modality in the treatment of end-stage renal disease, but there is a decline in the number of patients on PD since early 2000's. This decline is due to higher morbidity and mortality associated with infection. Peritonitis is the most common infection related to peritoneal dialysis. Peritonitis rates and causative organisms are different in every center. Here we present the rates of peritonitis and causative organisms of 440 patients with end-stage renal disease receiving peritoneal dialysis over a period of six years in Baskent University Faculty of Medicine Hospital, Nephrology department. Between the years 2000-2006, 620 peritonitis episodes occurred during a cumulative observation time of 12012,9 patient-months. 61,6 % of the patients had at least one episode of peritonitis during this period. We found that patients with the history of prior hemodialysis therapy and prior catheter related infection have statically higher incidence of peritonitis. The cohort-specific peritonitis incidence was 0,62 episodes per patient-year. Between the years 2000-2006, coagulase-negative staphylococcus was the most common cause of peritonitis (17,1 %). The 37,6 % of the all peritonitis episodes were caused by Gram-positive organisms, 12,7 % of them were caused by Gram-negative organisms and 0, 5% of them were caused by fungi. The rate of culture-negative peritonitis was 49, 2 %.When the patients were divided according to the observed years, it is found that peritonitis rates and the microbiological patterns have changed. The cohort-specific peritonitis incidence was 0, 79 episodes per patient-year between the years 2000-2003 and 0, 46 episodes per patient-year between the years 2003-2006. Between the years 2000-2003 culture-negative peritonitis rate was 53, 1%, whereas it has decreased to 43, 2 % between the years 2003-2006. The incidence of E Coli and MRKNS were statically different in the two groups. Every center should make an effort to find out the spectrum of organisms and antibiotic resistance rates of their own center for determining of the appropriate empirical therapy. For all of the peritoneal dialysis centers, the most important point seems to be education. Rather than conventional culture methods, automatized blood culture systems should be used to isolate the organisms for obtaining successful treatment.