Peritoneal Dialysis-related Peritonitis in Children: A Single Center's Experience Over 12 Years

ABSTRACT

PURPOSE: The aim of our study was to investigate the characteristics of the peritoneal dialysis (PD) - related peritonitis and to evaluate the effectiveness of the empirical antibiotics recommended by the International Society for Peritoneal Dialysis in Korean children. METHODS: We retrospectively reviewed the medical records of 72 children on peritoneal dialysis at the Department of Pediatrics, Asan Medical Center over the period from March 2000 to February 2012. RESULTS: Seventy-nine episodes of peritonitis occurred in 32 patients. The incidence of peritonitis was 0.43 episodes/patient.year. There were no significant differences in the incidence of peritonitis in terms of dialysis modality (P=0.459). Twenty-one patients experienced 51 catheter exit-site infections (0.28 episode/patient.year). There were no significant differences in the incidence of peritonitis between those with and without history of exit-site infections (P=0.721). Specific pathogens were isolated from 68.4% (54/79) of the patient with peritonitis episodes, including Gram-positive bacteria (n=34), Gram-negative bacteria (n=25) and fungus (n=1). Among Gram-positive bacteria, 85.3% of the isolates were susceptible to beta-lactam antibiotics, among Gram-negative rods, 94.7% of the isolates were susceptible to ceftazidime. Among 25 cases with unknown etiologies, 92.0% of cases demonstrated satisfactory responses to cefazolin and ceftazidime. CONCLUSIONS: The incidence of peritonitis was 0.43 episodes/patient.year. Initial empirical therapy consisting of cefazolin and ceftazidime was appropriate for 91.1% of the PD-related peritonitis treatment. Continuous monitoring for the emergence of the resistant organisms is an important part of the appropriate managements of PD-related peritonitis.