Conflict of Interest: None.
Epidemiology of culture isolates from peritoneal dialysis peritonitis patients in southern India using an automated blood culture system to culture peritoneal dialysate
Article first published online: 19 MAY 2010
© 2011 The Authors. Journal compilation © 2011 Asian Pacific Society of Nephrology
Volume 16, Issue 1, pages 63–67, January 2011
How to Cite
GUPTA, S., MURALIDHARAN, S., GOKULNATH and SRINIVASA, H. (2011), Epidemiology of culture isolates from peritoneal dialysis peritonitis patients in southern India using an automated blood culture system to culture peritoneal dialysate. Nephrology, 16: 63–67. doi: 10.1111/j.1440-1797.2010.01355.x
Financial Support: None.
- Issue published online: 23 DEC 2010
- Article first published online: 19 MAY 2010
- Accepted manuscript online: 28 JUN 2010 07:07AM EST
- Accepted for publication 4 May 2010.Accepted manuscript online 19 May 2010.
- BACTEC 9050;
- continuous ambulatory peritoneal dialysis;
- microbiological culture;
- peritoneal dialysis fluid;
Aim: Continuous ambulatory peritoneal dialysis (CAPD) is a major form of therapy for chronic end stage renal disease patients, which may lead to CAPD-associated peritonitis. The spectrum of organisms associated with CAPD peritonitis varies geographically. Not much data is available regarding this from southern India. The aim of this study was to characterize the spectrum of organisms associated with CAPD peritonitis in this region and observe the utility of automated blood culture systems to culture peritoneal dialysate.
Methods: Ninety episodes of peritonitis were cultured over a span of 3 years using an automated blood culture system.
Results: The yield of culture positivity was 50%. The most predominant organism was found to be coagulase-negative Staphylococcus spp. (21.1%) followed by Enterobacteriaceae (12.2%). Other organisms isolated were non-fermenting Gram-negative bacilli (4.4%), Pseudomonas aeruginosa (3.3%), α-haemolytic Streptococci (3.3%), Candida spp. (2.2%), Staphylococcus aureus (1.1%), β-haemolytic Streptococci (1.1%) and Micrococci (1.1%). A high degree of resistance to third generation cephalosporins (66.7%) was noted amongst the Gram-negative bacilli. Also, all the Gram-negative bacilli isolated from patients who had prior empirical antibiotic therapy of ceftazidime before arrival at the centre, were resistant to third generation cephalosporins.
Conclusion: A varied spectrum of organisms isolated from peritoneal dialysate compared to the global scenario was observed. Also, a high degree of third generation cephalosporin resistance was noted amongst the Gram-negative bacilli. Thus, it is suggested that the empirical therapy should be dependent on the local epidemiology.