The Report of Causative Organisms in Peritonitis from the Database of Peritoneal Dialysis in Thailand Excelprogram

Abstract

The peritonitis (PN) is one important clinical outcome which should be monitored by peritoneal dialysis units. To report the types of pathogens isolated from patients with peritoneal dialysis who had peritonitis. We have developed a web-based program named the Database of Peritoneal dialysis in the EXcel (DPEX). It is a program for peritoneal dialysis units to use for monitoring clinical outcomes of patients with peritoneal dialysis (PD) for continuous quality improvement. We have analyzed the data of PD patients with peritonitis during November, 2007 to September, 2015.The causative organisms were classified by cultures. The 2 month outcomes of PN consisted of the continuation of PD, technique failure or mortality rates were evaluated. The technique failure was defined as catheter removal and/or a shift to permanent hemodialysis. There were 1,300 (51.9%) males and 1,207 (48.1%)females .The mean (SD) age when PD was initiated was 54.1 (15.2) [95%CI 53.5-54.7] years. Patients with diabetes numbered 1,367 (54.5%). Patients were categorized with education levels as illiterate, primary school, secondary school, university and unknown were 728 (29%), 1,288 (51.4%), 354 (14.1%), 63 (2.5%), and 74 (3%), respectively. Universal health coverage scheme covered 2,341 (93.4%) of the cases. The numbers of gram positive, gram negative, culture negative, fungal, mycobacterial and polymicrobial PN were 1,332 (31.8%), 1,179 (28.1%), 1,498 (35.7%), 141 (3.4%), 25 (0.6%), and 15 (0.4%), respectively. The most common gram positive pathogens were Staphylococcus spp (coagulase negative and coagulase positive, not including S.aureus) 339 (25.5%) followed by Streptococcal spp. 288 (21.6%). Also, Staphylococcus aureusspp was identified in216 (16.2%). The most common gram negative pathogens were E.coli429 (36.4%) followed by Klebsiella spp. 196 (16.6%), and P.aeruginosa 142 (12.0%). The patients who continued PD, had technique failure and mortality at2,079 (82.9%), 233 (9.3%) and 178 (7.1%), respectively. There were 17 (0.7%) cases that could not be evaluated as they were transferred to other PD centers. The numbers of culture negative PN were high. Most patients who contracted PN were able to continue with PD.