https://scholars.lib.ntu.edu.tw/handle/123456789/478607
Title: | Viridans streptococci in peritoneal dialysis peritonitis: Clinical courses and long-term outcomes | Authors: | CHIA-TER CHAO SZU-YING LEE WEI-SHUN YANG HUEI-WEN CHEN CHENG-CHUNG FANG CHUNG-JEN YEN CHIH-KANG CHIANG KUAN-YU HUNG JENQ-WEN HUANG |
Issue Date: | 2015 | Journal Volume: | 35 | Journal Issue: | 3 | Start page/Pages: | 333-341 | Source: | Peritoneal Dialysis International | Abstract: | ? Background: The clinical courses and long-term outcomes of viridans streptococcus (VS) peritoneal dialysis (PD) peritonitis remain unclear. ? Methods: We conducted a retrospective analysis of all PD patients in a single center with gram-positive cocci (GPC) peritonitis between 2005 and 2011, and divided them into 3 groups: VS, other streptococci and other GPC (apart from VS). Clinical characteristics and outcomes of the VS group were compared with the other streptococci and other GPC groups, with prognostic factors determined. ? Results: A total of 140 patients with 168 episodes of GPC peritonitis (44% of all peritonitis) were identified over 7years. Among these, 18 patients (13%) developed VS peritonitis, while 14 patients (10%) developed other streptococcal peritonitis. Patients with VS peritonitis had a high cure rate by antibiotic alone (94%), despite a high polymicrobial yield frequency (28%). We found that VS peritonitis carried a lower risk of Tenckhoff catheter removal and relapsing episodes than other GPC peritonitis (6% vs 11%), and a lower mortality than other streptococci peritonitis (0% vs 7%). However, after the index peritonitis episodes, VS, other streptococci, and other GPC group had a significantly increased peritonitis incidence compared with the period before the index peritonitis (all p < 0.01). Patients with VS peritonitis had a significantly higher incidence of refractory peritonitis compared with other streptococci or other GPC peritonitis in the long term (both p < 0.01). ? Conclusions: VS poses a higher risk of subsequent refractory peritonitis after the index episode as compared with other streptococcal or GPC peritonitis. It might be prudent to monitor the technique of these patients with VS peritonitis closely to avoid further peritonitis episodes. ? 2015 International Society for Peritoneal Dialysis. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/478607 | ISSN: | 0896-8608 | DOI: | 10.3747/pdi.2013.00108 | SDG/Keyword: | adult; alpha hemolytic Streptococcus; Article; clinical feature; comorbidity; continuous renal replacement therapy; demography; disease course; end stage renal disease; female; follow up; human; human experiment; major clinical study; male; middle aged; morbidity; mortality; pathogenesis; peritoneal dialysis; peritonitis; priority journal; prospective study; retrospective study; survival rate; treatment outcome; adverse effects; alpha hemolytic Streptococcus; incidence; isolation and purification; Kidney Failure, Chronic; microbiology; peritoneal dialysis; peritonitis; Streptococcal Infections; Taiwan; time factor; Female; Female; Follow-Up Studies; Follow-Up Studies; Humans; Humans; Incidence; Incidence; Kidney Failure, Chronic; Kidney Failure, Chronic; Male; Male; Middle Aged; Middle Aged; Peritoneal Dialysis; Peritoneal Dialysis; Peritonitis; Peritonitis; Retrospective Studies; Retrospective Studies; Streptococcal Infections; Streptococcal Infections; Taiwan; Taiwan; Time Factors; Time Factors; Viridans Streptococci; Viridans Streptococci |
Appears in Collections: | 醫學院附設醫院 (臺大醫院) |
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