Unexpected Gram-Negative Peritonitis Associated with Previous Exit-Site Infection in Peritoneal Dialysis Patients

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Objectives: The aim of this study was to determine the risk of development of peritoneal dialysis (PD) related peritonitis caused by different microorganisms in patients with catheter associated infections.
Methods: In study from the 1st of January 2012 to the 11th of November 2017 212 PD patients from Pauls Stradiņš Clinical University Hospital Nephrology Centre were included where retrospective analysis was done, using PD registry data. Clinical data included previous PD catheter exit-site infections (ESI) and tunnel infection were compared between group with peritonitis and control group who had not PD-related peritonitis. Odds ratio (OR) for each factor was calculated using binary logistic regression, afterwards data adjustment was done (IBM SPSS 20.0).
Results: The study included 101 (47.9%) women, 110 men (52.1%). Median age in control group was 57.0 year, in peritonitis group – 64.0. 98 patients (46.4%) had peritonitis, 189 peritonitis episodes in total. The incidence of peritonitis was 0.495 episodes/patient-year. Gram-positive peritonitis, when compared to the control group, was associated with previous ESI 76.0% vs 42.5% (p = 0.001, OR = 3.516) and tunnel infection 13.5% vs 2.7% (p = 0.034, OR = 4.300). Gram-negative peritonitis was associated with previous ESI 88.4% vs 42.5% (p = 0.001, OR = 9.605), but wasn’t associated with tunnel infection 9.3 vs 2.7% (p = 0.092, OR = 3.761). Culture-negative peritonitis tend to appear twice frequently in patients with previous ESI 61.8% vs 42.5% (p = 0.078, OR = 2.081) and tunnel infection 5.9% vs 2.7% (p = 0.375, OR = 2.292) with non-significant association.
Conclusions: Previous ESI increases the likelihood of developing both, Gram-positive and, surprisingly, also Gram-negative peritonitis. Tunnel infections are mostly associated with Gram-positive peritonitis. Culture-negative peritonitis wasn’t associated with previous ESI and tunnel infection. Causative microorganisms of Gram-positive and Gram-negative peritonitis are different from causative micro- organisms
of previous ESI in most PD patients. Further prospective research is needed to clarify the association of gram-negative peritonitis with PD catheter ESI.


ConferenceRSU International Research Conference 2019
OtherThe Conference will be held within the framework of RSU Research Week 2019.

RSU starptautiskā konference "Zināšanas praksei" medicīnas un veselības aprūpes nozarē 2019.
Internet address

Field of Science*

  • 3.2 Clinical medicine

Publication Type*

  • 3.4. Other publications in conference proceedings (including local)


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