The Epidemiology of Peritoneal Dialysis Related Bacterial Peritonitis in Maharaj Nakhon Si Thammarat Hospital

Abstract

Background: Peritoneal dialysis related bacterial peritonitis remains the major complication, leading to technical failure and mortality among peritoneal dialysis patients. In order to reduce the incidence of PD-related bacterial peritonitis, investigating the causative pathogens and risk factors was warranted.

 Objective: To identify causative pathogens of peritoneal dialysis related infection. Described factors associated with peritoneal dialysis related bacterial peritonitis and treatment outcome among peritoneal dialysis patients at Maharaj Nakhon Si Thammarat Hospital.

 Materials and Methods: This was a descriptive study. We retrospectively reviewed medical records of all peritoneal dialysis patients who treated at Maharaj Nakhon Si Thammarat Hospital between January 2009 and May 2019. Data were analyzed by using descriptive statistics include frequencies, percentages, and T-Test.

Results: During the study period, there were 535 PD-related bacterial peritonitis episodes among 337 CAPD patients, 85 patients were reported more than 1 episode of PD-related peritonitis. The most common causative bacterial pathogen were CoNs (12.5%), Streptococcus spp. (10.3%), E. coli (10.1%) and S. aureus (9.5%). The major factor (25.8%) associated with peritonitis was touch contamination or did not follow aseptic technique. The risk factors for mortality in PD-related bacterial peritonitis were dialysis vintage > 30 months (p=0.002), hypoalbuminemia (p=0.016), and hypokalemia (p=0.049).

Conclusion: The most common causative pathogen in PD-related bacterial peritonitis were gram positive bacteria, the risk associated with touch contamination and aseptic technique incorrect. Therefore, re-training program may reduce peritonitis risk.