Peritoneal dialysis-associated peritonitis

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