Peritoneal dialysis-associated peritonitis - Revision history

Aidan: /* Further Reading */

2021-06-03T14:14:09Z

Aidan: /* Further Reading */

2021-06-03T14:13:13Z

Aidan at 14:57, 2 June 2021

2021-06-02T14:57:10Z

← Older revision		Revision as of 14:57, 2 June 2021
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	===Microbiology===		===Microbiology===

			*Gram-positive bacteria (45%)
	*[[Coagulase-negative staphylococci]]		**[[Coagulase-negative staphylococci]]
	*[[Staphylococcus aureus]]		**[[Staphylococcus aureus]]
	*[[Streptococci]]
	*[[~~Diphtheroids~~]]		**[[Streptococci]]
			**[[Diphtheroids]]
	*[[Gram-negative bacteria]], if underlying GI pathology		*[[Gram-negative bacteria]] (15%), especially if underlying GI pathology
			*Mixed bacterial (1-2%)
			*Fungal (1%), particularly [[Candida]]
			*[[Tuberculosis]] (<1%)

	===Pathophysiology===		===Pathophysiology===
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	*[[Peritonitis]], with diffuse abdominal pain and tenderness and cloudy or purulent dialysate		*[[Peritonitis]], with diffuse abdominal pain and tenderness and cloudy or purulent dialysate
			*Often afebrile
	*Typically no fever
			*Dialysate may have elevated WBCs >100 cells/mcL with >50% neutrophils

			== Diagnosis ==

			* Aspirate dialysate, then centrifuge and inoculate into blood culture bottles (for both aerobic and anaerobic organisms)

	==Management==		==Management==

			*Empiric treatment should cover [[coagulase-negative staphylococci]] and gram-negatives, so [[vancomycin]] plus [[ceftriaxone]] or [[ceftazidime]] would be reasonable
	*Intraperitoneal antibiotics are preferred unless systemic infection or bacteremia		*Intraperitoneal antibiotics are preferred unless systemic infection or bacteremia
			*May attempt to salvage the catheter, especially for less virulent organisms like [[coagulase-negative staphylococci]]
			*Indications for catheter removal include
			**Difficult-to-treat organisms ([[Candida]], [[Staphylococcus aureus]], resistant Gram-negatives like [[Pseudomonas]] or [[Stenotrophomonas]])
			**Bowel perforation
			**Relapse with same organism within a month
			**Clinical failure despite 5 days of appropriate antibiotics
			**Exit site infection
	*Duration 14 to 21 days, or 1 week after catheter removal		*Duration 14 to 21 days, or 1 week after catheter removal

			== Further Reading ==

			* ISPD Peritonitis Recommendations: 2016 Update on Prevention and Treatment. ''Perit Dial Int''. 2016;36:481. doi: [https://doi.org/10.3747/pdi.2016.00078 10.3747/pdi.2016.00078]

	[[Category:Infectious syndromes]]		[[Category:Infectious syndromes]]

Aidan at 18:39, 7 February 2021

2021-02-07T18:39:10Z

← Older revision		Revision as of 18:39, 7 February 2021
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	== Background ==		==Background==

		⚫	===Microbiology===
⚫	* On average one episode per patient per year

		⚫	*[[Coagulase-negative staphylococci]]
⚫	=== Microbiology ===
		⚫	*[[Staphylococcus aureus]]
		⚫	*[[Streptococci]]
		⚫	*[[Diphtheroids]]
		⚫	*[[Gram-negative bacteria]], if underlying GI pathology

		⚫	===Pathophysiology===
⚫	* [[Coagulase-negative staphylococci]]
⚫	* [[Staphylococcus aureus]]
⚫	* [[Streptococci]]
⚫	* [[Diphtheroids]]
⚫	* [[Gram-negative bacteria]], if underlying GI pathology

		⚫	*Acquired from catheter, exit site, dialysate fluid, or transmural migration
⚫	== Pathophysiology ==

			=== Epidemiology ===

		⚫	* On average one episode per patient per year

		⚫	==Clinical Manifestations==
⚫	* Acquired from catheter, exit site, dialysate fluid, or transmural migration

		⚫	*[[Peritonitis]], with diffuse abdominal pain and tenderness and cloudy or purulent dialysate
⚫	== Clinical Manifestations ==
		⚫	*Typically no fever

		⚫	==Management==
⚫	* [[Peritonitis]], with diffuse abdominal pain and tenderness and cloudy or purulent dialysate
⚫	* Typically no fever

		⚫	*Intraperitoneal antibiotics are preferred unless systemic infection or bacteremia
⚫	== Management ==
		⚫	*Duration 14 to 21 days, or 1 week after catheter removal

			[[Category:Infectious syndromes]]
⚫	* Intraperitoneal antibiotics are preferred unless systemic infection or bacteremia
			[[Category:Nephrology]]
⚫	* Duration 14 to 21 days, or 1 week after catheter removal

Aidan: Created page with "== Background == * On average one episode per patient per year === Microbiology === * Coagulase-negative staphylococci * Staphylococcus aureus * Streptococci *..."

2020-08-24T12:39:19Z

Created page with "== Background == * On average one episode per patient per year === Microbiology === * Coagulase-negative staphylococci * Staphylococcus aureus * Streptococci *..."

New page

== Background ==

* On average one episode per patient per year

=== Microbiology ===

* [[Coagulase-negative staphylococci]]
* [[Staphylococcus aureus]]
* [[Streptococci]]
* [[Diphtheroids]]
* [[Gram-negative bacteria]], if underlying GI pathology

== Pathophysiology ==

* Acquired from catheter, exit site, dialysate fluid, or transmural migration

== Clinical Manifestations ==

* [[Peritonitis]], with diffuse abdominal pain and tenderness and cloudy or purulent dialysate
* Typically no fever

== Management ==

* Intraperitoneal antibiotics are preferred unless systemic infection or bacteremia
* Duration 14 to 21 days, or 1 week after catheter removal

← Older revision		Revision as of 14:14, 3 June 2021
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	* ISPD Peritonitis Recommendations: 2016 Update on Prevention and Treatment. ''Perit Dial Int''. 2016;36:481. doi: [https://doi.org/10.3747/pdi.2016.00078 10.3747/pdi.2016.00078]		* ISPD Peritonitis Recommendations: 2016 Update on Prevention and Treatment. ''Perit Dial Int''. 2016;36:481. doi: [https://doi.org/10.3747/pdi.2016.00078 10.3747/pdi.2016.00078]
	* ISPD Catheter-Related Infection Recommendations: 2017 Update. ''Perit Dial Int''. 2017;37:141-154. doi: [https://doi.org/10.3747/pdi.2016.00120 10.3747/pdi.2016.00120]		* ISPD Catheter-Related Infection Recommendations: 2017 Update. ''Perit Dial Int''. 2017;37:141-154. doi: [https://doi.org/10.3747/pdi.2016.00120 10.3747/pdi.2016.00120]
			** Focuses on exit site infections

	[[Category:Infectious syndromes]]		[[Category:Infectious syndromes]]

← Older revision		Revision as of 14:13, 3 June 2021
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	* ISPD Peritonitis Recommendations: 2016 Update on Prevention and Treatment. ''Perit Dial Int''. 2016;36:481. doi: [https://doi.org/10.3747/pdi.2016.00078 10.3747/pdi.2016.00078]		* ISPD Peritonitis Recommendations: 2016 Update on Prevention and Treatment. ''Perit Dial Int''. 2016;36:481. doi: [https://doi.org/10.3747/pdi.2016.00078 10.3747/pdi.2016.00078]
			* ISPD Catheter-Related Infection Recommendations: 2017 Update. ''Perit Dial Int''. 2017;37:141-154. doi: [https://doi.org/10.3747/pdi.2016.00120 10.3747/pdi.2016.00120]

	[[Category:Infectious syndromes]]		[[Category:Infectious syndromes]]