Research Article
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Year 2019, Volume: 10 Issue: 37, 41 - 45, 06.10.2019
https://doi.org/10.17944/mkutfd.541192

Abstract

References

  • Liakopoulos V, Nikitidou O, Kalathas T, Roumeliotis S, Salmas M, Eleftheriadis T. Peritoneal dialysis-related infections recommendations: International Society of Peritoneal Dialysis (ISPD) 2016 update. What is new?. Int Urol Nephrol 2017;49(12):2177-2184.
  • Gupta S, Muralidharan S, Gokulnath, Srinivasa H. Epidemiology of culture isolates from peritoneal dialysis peritonitis patients in Southern India using an automated blood culture system to culture peritoneal dialysate. Nephrology (Carlton.) 2011;16:63-7.
  • Levison ME, Bush LM. Peritonitis and intraperitoneal abscesses. In: Mandell GL, Bennett JE, Dolin R, (Editors). Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 7th ed. Philadelphia: Churchill Livingstone, 2010.p.1027-1030.
  • JM Burkart. Microbiology and therapy of peritonitis in peritoneal dialysis – UpToDate.
  • Li PK-T, Szeto CC, Piraino B, de Arteaga J, Fan S, Figueiredo AE, et al. ISPD Peritonitis recommendations: 2016 update on prevention and treatment. Perit Dial Int 2016; 36:481–508.
  • The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 4.0, 2014. Erişim:http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/Breakpoint_table_v_4.0.pdf
  • van Diepen AT, Tomlinson GA, Jassal SV. The association between exit site infection and subsequent peritonitis among peritoneal dialysis patients. Clin J Am Soc Nephrol 2012; 7:1266–71.
  • Kotsanas D, Polkinghorne KR, Korman TM, Atkins RC, Brown F. Risk factors for peritoneal dialysis-related peritonitis: can we reduce the incidence and improve patient selection? Nephrology 2007; 12: 239-45.
  • Chow KM, Szeto CC, Leung CB, Kwan BC, Law MC, Li PK. A risk analysis of continuous ambulatory peritoneal dialysis-related peritonitis. Perit Dial Int 2005; 25:374–9.
  • McDonald SP, Collins JF, Rumpsfeld M, Johnson DW. Obesity is a risk factor for peritonitis in the Australian and New Zealand peritoneal dialysis patient populations. Perit Dial Int 2004; 24:340–6.
  • Steer JA, Hill GB, Srinivasan S, Southern J, Wilson AP: Slime production, adherence and hydrophobicity in coagulase-negative staphylococci causing peritonitis in peritoneal dialysis. J Hosp Infect 1997;37:305-316.
  • Read RR, Eberwein P, Dasgupta MK, Grant SK, Lam K, Nickel JC, et al: Peritonitis in peritoneal dialysis: Bacterial colonization by biofilm spread along the catheter surface. Kidney Int 1989;35:614-621
  • Abraham G, Gupta A, Prasad KN, Rohit A, Bhalla AK,et al.Microbiology, clinical spectrum and outcome of peritonitis in patients undergoing peritoneal dialysis in India: Results from a multicentric, observational study.Indian J Med Microbiol 2017;35(4):491-498.
  • Karadenizli A, Yeğenağa-Bakioğlu I, Kolaylı F, Koçanali Y, Bingöl R. Kronik ambulatuar periton diyalizi hastalarının bakteriyolojik yönden irdelenmesi. Klimik Derg 2002;15:59-51.
  • Çolak B, Hızel K, Güz G ve ark. Periton diyaliz hastalarında peritonit sıklığı ve risk faktörleri. Flora Dergisi. 2004;9:266-70.
  • Sharma RK, Kumar J, Gupta A, Gulati S. Peritoneal infection in acute intermittent peritoneal dialysis. Ren Fail 2003;25:975-80.
  • Gloor HJ, Pandolfi S, Rüttimann S. 20 years of peritoneal dialysis in a mid-sized Swiss hospital. Swiss Med Wkly 2003; 133: 619-24.
  • Leppanen H, Metsarinne KP, Nikoskelainen J, Tertti R. Three-year analysis of microbial aetiology and antimicrobial susceptibilities of PD peritonitis. Scan J Infect Dis 2006; 38: 645-49.
  • Kavanagh D, Prescott GJ, Mactier RA. Peritoneal dialysis-associated peritonitis in Scotland (1999-2002). Nephrol Dial Transplant 2004; 19: 2584-91.
  • Dasgupta MK, Ulan RA, Bettcher KB, et al. Effects of exit site infection and peritonitis on the distribution of biofilm-encased adherent bactereial microcolonies (BABM) on Tenchkhoff (T) catheters in patients undergoing continuous ambulatory. In: Advances in Continuous Ambulatory Peritoneal Dialysis, Khanna R, Nolph KD, Prowand BF, et al (Eds), University of Toronto Press. Toronto. 1986.102.
  • Naz H , Şahin G , Serbest S , Yalçın AU. Periton Diyalizi İle İlişkili Peritonit: 179 Atağın Değerlendirilmesi. Mikrobiyol Bül 2008; 42: 265-272.
  • Koruk ST, Yetkin MA, Koruk İ, Erdinç FŞ, Şahan S, Tülek N. Sürekli Ayaktan Periton Diyalizi Uygulanan Hastalarda Gelişen Peritonit Ataklarının Değerlendirilmesi. Flora Derg. 2006;11(1):24-31.
  • Ramanathan K, Padmanabhan G, Vijayaraghavan B. Evaluation of continuous ambulatory peritoneal dialysis fluid C-reactive protein in patients with peritonitis. Saudi J Kidney Dis Transpl 2016; 27(3): 467-72.
  • Troidle L, Finkelstein F. Treatment and out- come of CPD-associated peritonitis. Ann Clin Microbiol Antimicrob 2006;5:6.
  • van Esch S, Krediet RT, Struijk DG. 32 years' experience of peritoneal dialysis-related peri- tonitis in a University Hospital. Perit Dial Int 2014;34:162-70.

Sürekli Ayaktan Periton Diyalizi Hastalarında Gelişen Peritonitlerin Epidemiyolojik ve Mikrobiyolojik Özelliklerinin Analizi

Year 2019, Volume: 10 Issue: 37, 41 - 45, 06.10.2019
https://doi.org/10.17944/mkutfd.541192

Abstract
















Amaç:

Sürekli Ayaktan Periton Diyalizi (SAPD) alan hastalarda
gelişen peritonitler, bu hastalardaki artmış hastane ve antibiyotik
maliyetlerinin, mortalite ve morbidite artışının en önemli nedenlerindendir.
Bu çalışmada, SAPD
hastalarında gelişen peritonitlerdeki etken 
mikroorganizmaların ve direnç profillerinin, bu hastalardaki demografik
verilerin belirlenmesi amaçlanmıştır.

Gereç ve Yöntemler:Ocak 2014- Ağustos 2018 tarihleri arasında, SAPD
tedavisi alan ve peritonit tanısıyla hastanemiz İç Hastalıkları Kliniği’ne
yatırılarak izlenen hastalar retrospektif olarak incelendi. Vaka grubunu
oluşturan hastaların demografik ve laboratuvar verileri otomasyon sistemi ve
tıbbi kayıtları incelenerek elde edildi. 


Bulgular:

Çalışmamıza
dahil edilen toplam 15 hastanın 7 (%46.7) 'si erkek, 8 (%53.3)'i kadın olup,
yaşları ortalaması 61.3 (47-78) yıl idi. 15 hastada gelişen toplam 44 peritonit
atağı retrospektif olarak incelendi. Nüks gelişen hastaların ilk epizoda etkili
antibiyotik tedavisini uygun sürede aldığı saptandı. Peritonit vakalarında en
sık sorumlu mikroorganizmalar koagulaz negatif stafilokoklar (%40.4) ve  Escherichia coli (%14.9) olarak
saptandı. Üç (%6.8) hastadan alınan kültürlerde
polimikrobiyal üreme saptandı. 32 (%68.1)
kültürde gram pozitif, 15 (%31.9) kültürde gram negatif bakteri üremesi oldu. Mantar üremesi ise saptanmadı.
Peritonit
vakalarının kültürlerinden üretilen bakterilerin çeşitli antibiyotiklere direnç
oranlarına
bakıldığında; gram pozitif bakterilerde en fazla direnç oksasiline (%56.25),
siprofloksasine (%
31.2),  gram
negatifler bakterilerde
ise en fazla
direnç
ampisiline (%73.3), sefuroksime (%66.6), seftriaksona (%60),
amoksisilin/klavulanik asite (%60)   karşı saptandı.

Sonuç:   Periton
diyalizi alan hastalardaki peritonitlerin yönetimi için, her merkez kendine ait
peritonit atak hızlarını takip etmeli ve
kabul edilemeyecek ölçüde yüksek olduğunda enfeksiyon kontrol
önlemlerinin gözden geçirilmelidir. Ayrıca
etken mikroorganizmalar ve
antibiyotik duyarlılıkları takip edilmeli ve ampirik tedaviler buna göre
düzenlenmelidir.

References

  • Liakopoulos V, Nikitidou O, Kalathas T, Roumeliotis S, Salmas M, Eleftheriadis T. Peritoneal dialysis-related infections recommendations: International Society of Peritoneal Dialysis (ISPD) 2016 update. What is new?. Int Urol Nephrol 2017;49(12):2177-2184.
  • Gupta S, Muralidharan S, Gokulnath, Srinivasa H. Epidemiology of culture isolates from peritoneal dialysis peritonitis patients in Southern India using an automated blood culture system to culture peritoneal dialysate. Nephrology (Carlton.) 2011;16:63-7.
  • Levison ME, Bush LM. Peritonitis and intraperitoneal abscesses. In: Mandell GL, Bennett JE, Dolin R, (Editors). Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 7th ed. Philadelphia: Churchill Livingstone, 2010.p.1027-1030.
  • JM Burkart. Microbiology and therapy of peritonitis in peritoneal dialysis – UpToDate.
  • Li PK-T, Szeto CC, Piraino B, de Arteaga J, Fan S, Figueiredo AE, et al. ISPD Peritonitis recommendations: 2016 update on prevention and treatment. Perit Dial Int 2016; 36:481–508.
  • The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 4.0, 2014. Erişim:http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/Breakpoint_table_v_4.0.pdf
  • van Diepen AT, Tomlinson GA, Jassal SV. The association between exit site infection and subsequent peritonitis among peritoneal dialysis patients. Clin J Am Soc Nephrol 2012; 7:1266–71.
  • Kotsanas D, Polkinghorne KR, Korman TM, Atkins RC, Brown F. Risk factors for peritoneal dialysis-related peritonitis: can we reduce the incidence and improve patient selection? Nephrology 2007; 12: 239-45.
  • Chow KM, Szeto CC, Leung CB, Kwan BC, Law MC, Li PK. A risk analysis of continuous ambulatory peritoneal dialysis-related peritonitis. Perit Dial Int 2005; 25:374–9.
  • McDonald SP, Collins JF, Rumpsfeld M, Johnson DW. Obesity is a risk factor for peritonitis in the Australian and New Zealand peritoneal dialysis patient populations. Perit Dial Int 2004; 24:340–6.
  • Steer JA, Hill GB, Srinivasan S, Southern J, Wilson AP: Slime production, adherence and hydrophobicity in coagulase-negative staphylococci causing peritonitis in peritoneal dialysis. J Hosp Infect 1997;37:305-316.
  • Read RR, Eberwein P, Dasgupta MK, Grant SK, Lam K, Nickel JC, et al: Peritonitis in peritoneal dialysis: Bacterial colonization by biofilm spread along the catheter surface. Kidney Int 1989;35:614-621
  • Abraham G, Gupta A, Prasad KN, Rohit A, Bhalla AK,et al.Microbiology, clinical spectrum and outcome of peritonitis in patients undergoing peritoneal dialysis in India: Results from a multicentric, observational study.Indian J Med Microbiol 2017;35(4):491-498.
  • Karadenizli A, Yeğenağa-Bakioğlu I, Kolaylı F, Koçanali Y, Bingöl R. Kronik ambulatuar periton diyalizi hastalarının bakteriyolojik yönden irdelenmesi. Klimik Derg 2002;15:59-51.
  • Çolak B, Hızel K, Güz G ve ark. Periton diyaliz hastalarında peritonit sıklığı ve risk faktörleri. Flora Dergisi. 2004;9:266-70.
  • Sharma RK, Kumar J, Gupta A, Gulati S. Peritoneal infection in acute intermittent peritoneal dialysis. Ren Fail 2003;25:975-80.
  • Gloor HJ, Pandolfi S, Rüttimann S. 20 years of peritoneal dialysis in a mid-sized Swiss hospital. Swiss Med Wkly 2003; 133: 619-24.
  • Leppanen H, Metsarinne KP, Nikoskelainen J, Tertti R. Three-year analysis of microbial aetiology and antimicrobial susceptibilities of PD peritonitis. Scan J Infect Dis 2006; 38: 645-49.
  • Kavanagh D, Prescott GJ, Mactier RA. Peritoneal dialysis-associated peritonitis in Scotland (1999-2002). Nephrol Dial Transplant 2004; 19: 2584-91.
  • Dasgupta MK, Ulan RA, Bettcher KB, et al. Effects of exit site infection and peritonitis on the distribution of biofilm-encased adherent bactereial microcolonies (BABM) on Tenchkhoff (T) catheters in patients undergoing continuous ambulatory. In: Advances in Continuous Ambulatory Peritoneal Dialysis, Khanna R, Nolph KD, Prowand BF, et al (Eds), University of Toronto Press. Toronto. 1986.102.
  • Naz H , Şahin G , Serbest S , Yalçın AU. Periton Diyalizi İle İlişkili Peritonit: 179 Atağın Değerlendirilmesi. Mikrobiyol Bül 2008; 42: 265-272.
  • Koruk ST, Yetkin MA, Koruk İ, Erdinç FŞ, Şahan S, Tülek N. Sürekli Ayaktan Periton Diyalizi Uygulanan Hastalarda Gelişen Peritonit Ataklarının Değerlendirilmesi. Flora Derg. 2006;11(1):24-31.
  • Ramanathan K, Padmanabhan G, Vijayaraghavan B. Evaluation of continuous ambulatory peritoneal dialysis fluid C-reactive protein in patients with peritonitis. Saudi J Kidney Dis Transpl 2016; 27(3): 467-72.
  • Troidle L, Finkelstein F. Treatment and out- come of CPD-associated peritonitis. Ann Clin Microbiol Antimicrob 2006;5:6.
  • van Esch S, Krediet RT, Struijk DG. 32 years' experience of peritoneal dialysis-related peri- tonitis in a University Hospital. Perit Dial Int 2014;34:162-70.
There are 25 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original Articles
Authors

Sevil Alkan Çeviker 0000-0003-1944-2477

Özgür Günal 0000-0002-7744-4123

Süleyman Sırrı Kılıç This is me 0000-0002-0238-8008

Mehmet Derya Demirağ This is me 0000-0001-5667-1805

Publication Date October 6, 2019
Submission Date March 17, 2019
Acceptance Date August 29, 2019
Published in Issue Year 2019 Volume: 10 Issue: 37

Cite

Vancouver Alkan Çeviker S, Günal Ö, Kılıç SS, Demirağ MD. Sürekli Ayaktan Periton Diyalizi Hastalarında Gelişen Peritonitlerin Epidemiyolojik ve Mikrobiyolojik Özelliklerinin Analizi. mkutfd. 2019;10(37):41-5.