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Article: Clinical course and outcomes of single-organism enterococcus peritonitis in peritoneal dialysis patients

TitleClinical course and outcomes of single-organism enterococcus peritonitis in peritoneal dialysis patients
Authors
KeywordsEnterococcus peritonitis
Renal failure
Issue Date2011
PublisherMultimed, Inc. The Journal's web site is located at http://pdiconnect.com
Citation
Peritoneal Dialysis International, 2011, v. 31 n. 5, p. 522-528 How to Cite?
AbstractBackground and Objectives: Enterococci are part of the normal flora of the gastrointestinal tract. They can cause enteric peritonitis, which is a serious complication of peritoneal dialysis (PD). However, the clinical course and outcome of PD-related Enterococcus peritonitis remainsunclear. Methods: We reviewed all Enterococcus peritonitis episodes occurring in our dialysis unit from 1995 to 2009. Results: During the study period, 1421 episodes of peritonitis were recorded. Of 29 episodes (2.0%) that were attributable to single-organism Enterococcus, 12 episodes were caused by E.   faecalis; 9, by E. faecium; and the remaining 8, by other Enterococcus species. The overall rate of ampicillin resistance was 41.4%. Recent use of antibiotics was associated with the development of ampicillin-resistant Enterococcus (ARE) peritonitis (hazard ratio: 12.53; p  = 0.04). The primary response rate of Enterococcus peritonitis was significantly higher than that of Escherichia coli peritonitis (89.7% vs. 69.9%, p  = 0.038), but the primary response rate was not significantly lower for ARE peritonitis than for ampicillin- susceptible Enterococcus (ASE) peritonitis (83.3% vs. 94.1%, p  = 0.553). However, significantly more patients with ARE had received vancomycin (83.3% vs. 23.5%, p  = 0.003), with a longer mean duration of vancomycin treatment (11.8 ± 6.9 days vs. 3.7 ± 6.8 days, p  = 0.005). Conclusions: Recent use of antibiotics was a risk factor for the development of ARE peritonitis. Outcomes in ASE and ARE peritonitis were similar, but vancomycin was required during treatment for ARE peritonitis, in turn possibly predisposing the patients to infections caused by vancomycin-resistant organisms. © 2011 International Society for Peritoneal Dialysis.
Persistent Identifierhttp://hdl.handle.net/10722/137412
ISSN
2015 Impact Factor: 1.298
2015 SCImago Journal Rankings: 0.683
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYip, Ten_HK
dc.contributor.authorTse, KCen_HK
dc.contributor.authorNg, Fen_HK
dc.contributor.authorHung, Ien_HK
dc.contributor.authorLam, MFen_HK
dc.contributor.authorTang, Sen_HK
dc.contributor.authorLui, SLen_HK
dc.contributor.authorLai, KNen_HK
dc.contributor.authorChan, TMen_HK
dc.contributor.authorLo, WKen_HK
dc.date.accessioned2011-08-26T14:24:32Z-
dc.date.available2011-08-26T14:24:32Z-
dc.date.issued2011en_HK
dc.identifier.citationPeritoneal Dialysis International, 2011, v. 31 n. 5, p. 522-528en_HK
dc.identifier.issn0896-8608en_HK
dc.identifier.urihttp://hdl.handle.net/10722/137412-
dc.description.abstractBackground and Objectives: Enterococci are part of the normal flora of the gastrointestinal tract. They can cause enteric peritonitis, which is a serious complication of peritoneal dialysis (PD). However, the clinical course and outcome of PD-related Enterococcus peritonitis remainsunclear. Methods: We reviewed all Enterococcus peritonitis episodes occurring in our dialysis unit from 1995 to 2009. Results: During the study period, 1421 episodes of peritonitis were recorded. Of 29 episodes (2.0%) that were attributable to single-organism Enterococcus, 12 episodes were caused by E.   faecalis; 9, by E. faecium; and the remaining 8, by other Enterococcus species. The overall rate of ampicillin resistance was 41.4%. Recent use of antibiotics was associated with the development of ampicillin-resistant Enterococcus (ARE) peritonitis (hazard ratio: 12.53; p  = 0.04). The primary response rate of Enterococcus peritonitis was significantly higher than that of Escherichia coli peritonitis (89.7% vs. 69.9%, p  = 0.038), but the primary response rate was not significantly lower for ARE peritonitis than for ampicillin- susceptible Enterococcus (ASE) peritonitis (83.3% vs. 94.1%, p  = 0.553). However, significantly more patients with ARE had received vancomycin (83.3% vs. 23.5%, p  = 0.003), with a longer mean duration of vancomycin treatment (11.8 ± 6.9 days vs. 3.7 ± 6.8 days, p  = 0.005). Conclusions: Recent use of antibiotics was a risk factor for the development of ARE peritonitis. Outcomes in ASE and ARE peritonitis were similar, but vancomycin was required during treatment for ARE peritonitis, in turn possibly predisposing the patients to infections caused by vancomycin-resistant organisms. © 2011 International Society for Peritoneal Dialysis.en_HK
dc.languageengen_US
dc.publisherMultimed, Inc. The Journal's web site is located at http://pdiconnect.comen_HK
dc.relation.ispartofPeritoneal Dialysis Internationalen_HK
dc.subjectEnterococcus peritonitisen_HK
dc.subjectRenal failureen_HK
dc.subject.meshAbdominal Pain - microbiology-
dc.subject.meshAnti-Bacterial Agents - therapeutic use-
dc.subject.meshGram-Positive Bacterial Infections - drug therapy - etiology-
dc.subject.meshPeritoneal Dialysis - adverse effects-
dc.subject.meshPeritonitis - drug therapy - microbiology-
dc.titleClinical course and outcomes of single-organism enterococcus peritonitis in peritoneal dialysis patientsen_HK
dc.typeArticleen_HK
dc.identifier.emailHung, I: ivanhung@hkucc.hku.hken_HK
dc.identifier.emailTang, S: scwtang@hku.hken_HK
dc.identifier.emailLai, KN: knlai@hku.hken_HK
dc.identifier.authorityHung, I=rp00508en_HK
dc.identifier.authorityTang, S=rp00480en_HK
dc.identifier.authorityLai, KN=rp00324en_HK
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.3747/pdi.2009.00260en_HK
dc.identifier.pmid21532006-
dc.identifier.scopuseid_2-s2.0-84856138178en_HK
dc.identifier.hkuros190905en_US
dc.identifier.hkuros211520-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84856138178&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume31en_HK
dc.identifier.issue5en_HK
dc.identifier.spage522en_HK
dc.identifier.epage528en_HK
dc.identifier.isiWOS:000295842800005-
dc.publisher.placeCanadaen_HK
dc.identifier.scopusauthoridYip, T=7004283977en_HK
dc.identifier.scopusauthoridTse, KC=7102609864en_HK
dc.identifier.scopusauthoridNg, F=7103125634en_HK
dc.identifier.scopusauthoridHung, I=7006103457en_HK
dc.identifier.scopusauthoridLam, MF=35300050600en_HK
dc.identifier.scopusauthoridTang, S=7403437082en_HK
dc.identifier.scopusauthoridLui, SL=7102379130en_HK
dc.identifier.scopusauthoridLai, KN=7402135706en_HK
dc.identifier.scopusauthoridChan, TM=36110804400en_HK
dc.identifier.scopusauthoridLo, WK=7201502414en_HK

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