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 ORIGINAL ARTICLE
Year : 2017  |  Volume : 35  |  Issue : 4  |  Page : 491-498

Microbiology, clinical spectrum and outcome of peritonitis in patients undergoing peritoneal dialysis in India: Results from a multicentric, observational study


1 Department of Nephrology, Madras Medical Mission, Chennai, India
2 Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
3 Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
4 Department of Microbiology, Madras Medical Mission, Chennai, India
5 Department of Nephrology, Sir Gangaram Hospital, New Delhi, India
6 Department of Nephrology, Apcx Kidney Care, Mumbai, India
7 Department of Nephrology, Care Hospital, Hyderabad, Telangana, India
8 Department of Nephrology, International Hospital, Guwahati, Assam, India
9 Department of Nephrology, Madurai Kidney Center and Transplantation Research Center, Madurai, India
10 Department of Nephrology, Fortis Hospital and Kidney Institute, Kolkata, West Bengal, India
11 Department of Nephrology, Renal Care Hospital, Trichy, Tamil Nadu, India
12 Department of Nephrology, St John's Medical College Hospital, Bengaluru, Karnataka, India
13 Department of Nephrology, Aditya Birla Memorial Hospital, Pune, Maharashtra, India
14 Department of Nephrology, Meenakshi Mission Hospital and Research Center, Madurai, India
15 Department of Nephrology, Kidney Hospital, Jalandhar, Punjab, India
16 Department of Nephrology, Southern Railway Hospital, Chennai, India
17 Department of Nephrology, MlOT International, Chennai, India
18 Department of Medical Research and Medical Affairs-Industry, Baxter Pvt. Ltd, India
19 Department of Nephrology, Regional Institute of Medical Sciences, lmphal, Manipur, India

Correspondence Address:
Dr. Georgi Abraham
4-A, Dr. J J Nagar, Mogappair, Chennai - 600 037, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmm.IJMM_17_392

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Background: Peritoneal dialysis (PD)-related peritonitis is a major risk factor for drop out of patients on continuous ambulatory PD (CAPD) and automated PD (APD). Factors affecting PD-related peritonitis and centre-specific microbiological data are lacking in India. A multicentric prospective observational study was designed to overcome the gaps in the existing data regarding causative organism and outcome. Methodology: The present study was a prospective, uncontrolled, open-label; observational study conducted in 21 centres representing all the four geographical regions (North, South, East and West) of India between April 2010 and December 2011. Results: A total of 244 patients on chronic PD with peritonitis were enrolled in the study (CAPD and APD), who met the inclusion criteria, from 21 centres covering the different geographical areas of India. Amongst the 85 samples that were culture positive, 38 (44.7%) were in the monsoon season followed by 23 (27.1%) in the post-monsoon, 18 (21.2%) during winter and 11 (12.9%) during summer. Maximum culture positivity (72.7%) was observed with automated culture technique. Microorganisms could be isolated in only 85 cases (35.3%) while the remaining samples were culture negative (156/241, 64.7% of samples). Organisms isolated were Gram-negative in 47.8%, Gram-positive in 36.7%, fungal in 13.3% and Mycobacterium tuberculosis in 2.2%. Conclusion: This large multicentre study of peritonitis offers insights into the aetiology and outcomes of infectious complications of chronic PD in India that are germane to clinical decision-making.






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