Peritonitis in children undergoing continuous ambulatory peritoneal dialysis
D. Powell, E. S. Luis, S. Calvin, T. McDaid and D. Potter
During a four-year period there were 77 episodes and 15 recurrences of
peritonitis in 30 children treated with continuous ambulatory peritoneal
dialysis for periods of one to 39 months (mean, 15.3 months). The incidence
was one episode per 6.0 patient-months. Organisms cultured included
Staphylococcus epidermidis (17 episodes), Staphylococcus aureus (15
episodes), and fungi (four episodes). Special culture techniques were
needed to ensure a high yield of positive cultures. Peritonitis was usually
treated with intraperitoneal administration of cefazolin sodium, and 61% of
the episodes were treated at home. There was one death, from Candida
peritonitis, and catheters were removed in 11 children because of resistant
or recurrent peritonitis (eight cases) or fungal peritonitis (three cases).
Peritonitis rates were highest in children who had difficulty performing
bag changes aseptically but who could not be transferred to hemodialysis
and in hospitalized patients.
