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Peritoneal dialysis related peritonitis is a major risk factor for drop-out of patients on continuous ambulatory peritoneal dialysis. Data on factors affecting outcome of chronic peritoneal dialysis related peritonitis and microbiology is limited. In this regard, a retrospective, observational study was conducted at Post Graduate Institute of Medical Education and Research, Chandigarh, India, wherein we reviewed medical records of chronic peritoneal dialysis patients for 3 years between 01 July 2015 and 30 June 2018. We abstracted data pertaining to social, demographic and clinical characteristics of patients, occurrence of peritonitis including microbiological spectrum and outcomes. Conventional culture method involving manual inoculation was used in initial 11⁄2 years, after which automated culture (BACTEC) was used. A total of 334 chronic peritoneal dialysis patients were screened retrospectively for infective peritonitis. Out of these, 74 patients had 97 episodes of peritonitis; 54 patients had single episode and 19 had two episodes (repeat-16 and relapsing-3) and none had preceding or ongoing exit site or tunnel infection. Occurrence of peritonitis was highest during monsoon (36%) and least during autumn (12%). Cumulative culture positivity was 39.2% with gram-positivity in 60.5% patients. Predominant microorganism was Staphylococcus epidermidis (23.7%) followed by Escherichia coli (13.2%). 51 patients (74 episodes) recovered with antibiotic therapy alone, while 23 patients required peritoneal catheter removal in view of refractory (n-20)/ fungal (n-3) peritonitis. 6.8% patients had peritonitis related mortality. Outcome with respect to recovery was comparable (76.3%) in culture positive and culture negative episodes.

Incidence, Microbiological Spectrum and Outcomes of Infective Peritonitis in Chronic Peritoneal Dialysis Patients