Peritonitis attacks in continuous ambulatory peritoneal dialysis patients and risk factors for gram negative bacteria peritonitis

SUMMARYIn this study, clinical and laboratory examinations of 46 peritonitis attacks of 35 patientshas been done. 19.6% of microscopic examinations of peritoneal samples on Gram stain wereconcordant with culture results. The samples were cultured on blood agar, eosin-methylenblue agar and Sabouraud dextrose agar after sentrifugation. The samples were also culturedinto automatized blood culture bottles and these two methods were comparised. Isolation rateswere 63% and 78.3% respectively. Automatized blood culture system was found moresuscesfull to isolate microorganisms.Gram positive microorganisms were isolated in 69.6% of peritonitis attacks and gramnegatives were in 27.7%. Coagulase negative staphylococci were the most prevalentmicroorganisms. Among gram negative microorganisms, Escherichia coli was most frequent.Gram positive and gram negative peritonitis attacks were compared and risk factors forgram negative peritonitis were determined. It is noticed that the rate of gram negativeperitonitis were increased in over 60 years old patients, however, the usage of gastric acidinhibitors and gastrointestinal pathologies which are risk factors for gram negative peritonitiswere similar in both groups. C-reactive protein (CRP) levels were significantly higher(>100mg/L) in gram negative peritonitis. Response to treatment were detected delayed ingram negative peritonitis and unresponsiveness to the treatment, requirement of change ofantimicrobial therapy and mortality were detected more frequent in this group.Urine test strips were found as a pactical and applicable method for evaluating whiteblood cell count comparing to classical methods.