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Exit site infection and peritonitis due to Serratia species in patients receiving peritoneal dialysis: Epidemiology and clinical outcomes
Author(s) -
Au Christy W. H.,
Yap Desmond Y. H.,
Chan Jasper F. W.,
Yip Terence P. S.,
Chan Tak M.
Publication year - 2021
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.13813
Subject(s) - medicine , peritoneal dialysis , peritonitis , serratia , antibiotics , surgery , ampicillin , epidemiology , carbenicillin , gastroenterology , microbiology and biotechnology , bacteria , pseudomonas , biology , genetics
Aim To study the epidemiology and clinical outcomes of catheter‐related infections of Serratia species in peritoneal dialysis (PD) patients. Methods We retrospectively reviewed the patient characteristics, antibiotics susceptibility/resistance patterns and treatment outcomes of exit site infection (ESI) and peritonitis due to Serratia in PD patients during the period of 2004 to 2017. Results One hundred and sixty‐one patients had Serratia ESI, of which 10 (6.2%) progressed to tunnel tract involvement and 11 (6.8%) developed PD peritonitis. Nineteen (11.8%) patients with Serratia ESI failed to respond to medical treatment and required catheter removal. Fifty‐six (34.8%) patients had repeat Serratia ESI, which occurred at 12.9 ± 13.6 months after the previous episode. Twenty‐two patients had Serratia peritonitis, which accounted for 1% of peritonitis during the study period. Ten (45.5%) patients responded to medical treatment while 12 (54.5%) patients required catheter removal. Nine patients (36.4%) failed to resume PD and were converted to long‐term haemodialysis. Two patients had repeat peritonitis at 2 months and 3 years, respectively, after the initial episode. Serratia species in PD patients showed high rates of resistance to ampicillin, and first‐ and second‐generation cephalosporins, but were generally susceptible to aminoglycosides, carboxy‐/ureido‐penicillins and carbapenems. Conclusion Our results suggest that Serratia ESI show low risk of progression to peritonitis and favourable response to medical therapy, while Serratia peritonitis was associated with high rates of catheter removal and peritoneal failure.