The incidence and causes of peritonitis among peritoneal dialysis patients: A retrospective medical record review.

Aim:

This study aimed to examine the incidence and causes of peritonitis among peritoneal dialysis (PD) patients in Singapore General Hospital (SGH).

Method:

This is a retrospective medical record review on all PD patients who first started PD between year 2012 to 2016. A total of 146 cases and 199 controls were gathered.  Patients who developed peritonitis (cases) were compared with patients with no peritonitis (control) during the study period. The incidence of peritonitis (excluding relapse) and the causes of peritonitis were reported.

Results:

Only 50 cases and 50 controls data were available to analyze. The mean age at the start of PD was 61 ± 16.2 years old. The median age of peritonitis patient was 65 years old (SD=15). The total number of peritonitis episodes during the study period was 67, and 1 of these episodes was relapsing.The incidence of peritonitis was one episode per 39 months and the mean duration to first episode of peritonitis was 14 months (SD=11.9). Findings on the first episode of peritonitis revealed 32% (n=16) were gram positive and 28% (n=7) were gram negative bacteria. Coagulase Negative Staphylococcus 18% (n=9) was the most common gram positive bacteria identified that is associated with touch contaminations while E-Coli 10 % (n=5). Univariate analysis did not find race, gender, smoking status, or prophylactic antibiotics before insertion of Tenckchoff catheter to be statistically significant in this preliminary analysis.

Conclusion:

Touch contaminations contributed to majority of the peritonitis cases as evidenced by the high numbers of Coagulase Negative Staphylococcus infection. However, a larger sample size is required in order to determine the risk factors of peritonitis among PD patients in SGH.