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Dialysis-associated peritonitis in children.
Chadha, Vimal; Schaefer, Franz S; Warady, Bradley A.
Afiliação
  • Chadha V; Department of Pediatrics, Section of Nephrology, Virginia Commonwealth University Medical Center, Richmond, VA, USA.
Pediatr Nephrol ; 25(3): 425-40, 2010 Mar.
Article em En | MEDLINE | ID: mdl-19190935
Peritonitis remains a frequent complication of peritoneal dialysis in children and is the most common reason for technique failure. The microbiology is characterized by a predominance of Gram-positive organisms, with fungi responsible for less than 5% of episodes. Data collected by the International Pediatric Peritonitis Registry have revealed a worldwide variation in the bacterial etiology of peritonitis, as well as in the rate of culture-negative peritonitis. Risk factors for infection include young age, the absence of prophylactic antibiotics at catheter placement, spiking of dialysis bags, and the presence of a catheter exit-site or tunnel infection. Clinical symptoms at presentation are somewhat organism specific and can be objectively assessed with a Disease Severity Score. Whereas recommendations for empiric antibiotic therapy in children have been published by the International Society of Peritoneal Dialysis, epidemiologic data and antibiotic susceptibility data suggest that it may be desirable to take the patient- and center-specific history of microorganisms and their sensitivity patterns into account when prescribing initial therapy. The vast majority of patients are treated successfully and continue peritoneal dialysis, with the poorest outcome noted in patients with peritonitis secondary to Gram-negative organisms or fungi and in those with a relapsing infection.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Peritonite / Diálise Peritoneal Ambulatorial Contínua Tipo de estudo: Etiology_studies / Guideline / Risk_factors_studies Limite: Child / Humans Idioma: En Revista: Pediatr Nephrol Assunto da revista: NEFROLOGIA / PEDIATRIA Ano de publicação: 2010 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Peritonite / Diálise Peritoneal Ambulatorial Contínua Tipo de estudo: Etiology_studies / Guideline / Risk_factors_studies Limite: Child / Humans Idioma: En Revista: Pediatr Nephrol Assunto da revista: NEFROLOGIA / PEDIATRIA Ano de publicação: 2010 Tipo de documento: Article País de afiliação: Estados Unidos