Pet-related peritonitis and its prevention in peritoneal dialysis: a case study.

Abstract

Infectious peritonitis is a major complication of peritoneal dialysis (PD), accounting for considerable mortality and morbidity of PD patients. Although the usual organisms associated with peritonitis are Staphylococci aureus, Staphylococci epidermidis, Pseudomonas species and other gram-negatives, peritonitis due to zoonotic organisms in the context of close contact with companion animals has been reported in literatures (1-12). On a literature review, 124 cases of peritonitis caused by 12 different zoonotic agents have been reported in PD patients. Thirty of them were following documented contacts with an animal with overall mortality of 13.5% (1). In 27% of the cases, the Tenckhoff catheter had to be removed (1). Pets are very popular in our society with 63% of households in the United States (2,3) and 45% in Europe (1) with at least one pet, dogs and cats being more popular (2). Evidence-based literature suggests that animals/pets are a life-time companion and can help a person better cope with stressful life events, provide psychological help for the isolated or elderly, decrease depression, improve activities of daily life and increase social interaction. Pets are considered part of the family in many households and have very close contacts with their owners. However, close contact with pets is one of the major risk factors for peritonitis caused by zoonotic organisms (4). In our dialysis unit, we also encountered a patient who had close contact with cats with 3 episodes of peritonitis due to Pasteurella multocida over a 6-month period. This prompted us to evaluate the prevalence of pets and pets-related peritonitis in our peritoneal dialysis patients, and to assess the impact of a training session on pet-related peritonitis.