The comparative study of peritoneal dialysis fluid volume to the culture positive of pathogen in patients infected with peritonitis
Keywords:peitoneal dialysis fluid, culture positive, Continuous Ambulatory Peritoneal Dialysis, peritonitis
Collecting peritoneal dialysis fluid for culture in patients who received Continuous Ambulatory Peritoneal Dialysis (CAPD) have culture negative rate higher than standard criteria. Therefore this diagnostic study has an interest in determining the consistency of the peitoneal dialysis fluid examining the effects of pathogen growth in patients with peritonitis between 5 ml. and 10 ml. at the Dialysis Unit, Nakornping Hospital. Samples were recruited specimens from 37 patients. The consistency was tested by using Kappa statistic analysis and the difference of proportion was tested by using McNemar’s test. The results showed that most of the samples were male (70.3%). The average age was 60.05 ± 11.56 years, the comorbidity was hypertension (97.3%). The CAPD initiation time to peritonitis was 36.92 ± 34.70 months. The number of peritonitis was 2.41 ± 1.98 episodes. The duration of peritonitis from previous episode 5.81 ± 8.49 months. The results of peitoneal dialysis fluid culture amount 5 ml. and 10 ml. found culture positive 78.4% and 73.0%, respectively. The most common pathogens were the Gram-positive bacteria, 55.2% and 55.6%, respectively. Consistency was found that the kappa coefficient was 0.85 (95% CI 0.66-1.00) showing that the peitoneal dialysis fluid culture test using a volume of 5 ml. can be highly consistent with the 10 ml. However, no significant changes of the results (p = 0.157) may be due to inadequacy of the testing power. In addition, the average treatment time was 20.73 ± 5.95 days, with an average cost of 4,537 ± 6.68 baht and most samples recovered from peritonitis by returning to CAPD (86.5%). This study found consistency of the two peritoneal dialysis fluid volume toward the culture positivity. Although there is no significant differences of proportions, 5 ml. of the peitoneal dialysis fluid solution is recommended for examination.