Microbial profile, peritoneal fluid white blood cell count, and outcome of peritoneal dialysis-related peritonitis at Indonesian tertiary hospital

Penulis: Christina Solin, Ro; Kumalawati, July; Yusra, Yusra; Indrasari, Nuri
Informasi
JurnalJournal of Global Infectious Diseases
PenerbitWolters Kluwer Medknow Publications
Volume & EdisiVol. 15,Edisi 3
Halaman108 - 112
Tahun Publikasi2023
ISSN0974777X
Jenis SumberScopus
Sitasi
Scopus: 1
Google Scholar: 1
PubMed: 1
Abstrak
Introduction: Peritonitis caused by peritoneal dialysis (PD) remains a common complication of continuous ambulatory PD (CAPD). The purpose of this study is to determine the microbial profile in CAPD-related peritonitis, the optimal cutoff of white blood cell (WBC) count, and the percentage of polymorphonuclear (PMN) in CAPD fluid in the prediction of CAPD-related peritonitis, together with the outcome of CAPD-related peritonitis at an Indonesian tertiary hospital. This is a retrospective cohort study of CAPD-related peritonitis patients at Indonesian tertiary hospitals from November 2020 to October 2022. Methods: Patients with suspected CAPD-related peritonitis who were tested for CAPD fluid culture and WBC count in CAPD fluid were eligible for this study. Patient's diagnosis and outcome obtained from medical records. Differences in clinical outcomes by category of microorganisms were analyzed with Fisher exact test. The Mann-Whitney test and receiver operating characteristic curve were used to determine optimal WBC and PMN cutoff. Results: This study included 58 patients and 102 episodes of CAPD-related peritonitis. CAPD-related peritonitis was caused by 29.4% Gram-negative bacteria, 21.5% Gram-positive bacteria, 7.8% fungi, and 6.9% polymicrobial bacteria. CAPD fluid WBC count >79 cells/μL and PMN percentage >50% had a sensitivity of 76.4% and a specificity of 92.9% in predicting CAPD-related peritonitis. There was a significant difference in outcome between Gram-negative and Gram-positive bacterial peritonitis. Conclusions: It is critical to understand the microbial profile in CAPD-related peritonitis. Lower WBC count cutoff points in CAPD fluids may improve sensitivity in predicting CAPD-related peritonitis. © 2023 Wolters Kluwer Medknow Publications. All rights reserved.
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