Abstract
D. Low, 5.1. Vas, D-G. Oreopoulos,
N. Dombros, R. Khanna and W. McCready In patients on CAPD 20% of all peritonitis is due to enteric organisms (EO). This abstract describes the clinical characteristics and outcome of 23 episodes of peritonitis caused by EO among 21 patients (8 men and 13 wollen). Their average age was 52 (24.77) years and the average duration of CAPD before infection was 7.4 (1.17) months. In 15 episodes (14 patients) a single organism was isolated: 3/15 (Enterobacteriaceae 2, Clostridium 1) episodes were asymptomatic and the patients were treated successfully as out-patients; in 9115 episodes, (Enterobacteriaceae 4, Pseudomonas aeruginosa 2, Enterococci 3) the patients had clinical peritonitis but responded well to peritoneal lavage with antibiotics after an average hospital stay of 12.3 (6.34) days. Of the last three patients, two (both Bacteroides fragilis) underwent laparotomy because of persistent infection while the third (E. coli) underwent laparotomy because of a ruptured aneurysm fro III a previous transplant nephrectomy. All patients are alive and 9/14 continue on CAPD. In 8 episodes (7 patients) two or more organisms were isolated (Enterobacteriaceae 9, Enterococcus 2, P. aeruginosa 2, B. fragilis 1, Acinetobacter 1, Strep. viridans I, Staph. aureus 1). Three patients underwent laparotomy because of persistent infection. Two patients died from related complications. The five who survived remained in hospital for an average of 50 (9-103) days and only two continue on CAPD. We concluded that the presence of B. fragilis or the combination of an enteric organism plus one or more other organisms has a grave prognosis and requires aggressive management.
Get full access to this article
View all access options for this article.