Fungal peritonitis in patients on continuous ambulatory peritoneal dialysis: A single centre Indian experience

K. N. Prasad, N. Prasad, Ashish Gupta, R. K. Sharma, A. K. Verma, A. Ayyagari

Research output: Contribution to journalArticle

Abstract

Background. Fungal peritonitis (FP) is a serious complication in patients on continuous ambulatory peritoneal dialysis (CAPD). We reviewed our FP cases to analyse the causative agents and possible risk factors in relation to FP and its outcome and mortality. Methods. Records of all FP cases were reviewed. FP was diagnosed based on effluent cell count and positive fungal culture in suitable media. Results. Between October 1993 and November 2001, 261 patients underwent CAPD. FP was detected in 28 patients, one episode in each patient (14.3% of the total peritonitis episodes). Candida species and dematiaceous fungi ± Candida species were responsible for 89.3 and 10.7% of episodes, respectively. Patients with preceding bacterial peritonitis (BP) developed FP more frequently (25.6%) than de novo cases (2.9%) (P <0.0001) and lower proportion of them continued CAPD (8.6% vs. 60%; P = 0.007). Mortality in patients having abdominal pain with and without fever, and catheter in situ was significantly higher than in those patients who did not have these risk factors (9/11 vs. 6/17, P = 0.01; 13/17 vs. 2/11, P = 0.003; 6/6, vs. 9/22, P = 0.01, respectively). Conclusions. Higher proportion of our patients had FP; preceding BP was a significant risk factor for development of FP and technique failure. Abdominal pain ± fever in patients and catheter in situ were identified as risk factors associated with mortality.

Original languageEnglish (US)
Pages (from-to)96-101
Number of pages6
JournalJournal of Infection
Volume48
Issue number1
DOIs
StatePublished - Jan 2004
Externally publishedYes

Fingerprint

Continuous Ambulatory Peritoneal Dialysis
Peritonitis
Candida
Abdominal Pain
Mortality
Fever
Catheters
Fungi
Cell Count

Keywords

  • Candida species
  • Curvularia species
  • Exophiala jeanselmei
  • Fungal peritonitis
  • Peritoneal dialysis
  • Phaeoacremonium parasiticum

ASJC Scopus subject areas

  • Applied Microbiology and Biotechnology
  • Microbiology
  • Parasitology
  • Virology
  • Immunology and Allergy
  • Infectious Diseases

Cite this

Fungal peritonitis in patients on continuous ambulatory peritoneal dialysis : A single centre Indian experience. / Prasad, K. N.; Prasad, N.; Gupta, Ashish; Sharma, R. K.; Verma, A. K.; Ayyagari, A.

In: Journal of Infection, Vol. 48, No. 1, 01.2004, p. 96-101.

Research output: Contribution to journalArticle

Prasad, K. N. ; Prasad, N. ; Gupta, Ashish ; Sharma, R. K. ; Verma, A. K. ; Ayyagari, A. / Fungal peritonitis in patients on continuous ambulatory peritoneal dialysis : A single centre Indian experience. In: Journal of Infection. 2004 ; Vol. 48, No. 1. pp. 96-101.
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abstract = "Background. Fungal peritonitis (FP) is a serious complication in patients on continuous ambulatory peritoneal dialysis (CAPD). We reviewed our FP cases to analyse the causative agents and possible risk factors in relation to FP and its outcome and mortality. Methods. Records of all FP cases were reviewed. FP was diagnosed based on effluent cell count and positive fungal culture in suitable media. Results. Between October 1993 and November 2001, 261 patients underwent CAPD. FP was detected in 28 patients, one episode in each patient (14.3{\%} of the total peritonitis episodes). Candida species and dematiaceous fungi ± Candida species were responsible for 89.3 and 10.7{\%} of episodes, respectively. Patients with preceding bacterial peritonitis (BP) developed FP more frequently (25.6{\%}) than de novo cases (2.9{\%}) (P <0.0001) and lower proportion of them continued CAPD (8.6{\%} vs. 60{\%}; P = 0.007). Mortality in patients having abdominal pain with and without fever, and catheter in situ was significantly higher than in those patients who did not have these risk factors (9/11 vs. 6/17, P = 0.01; 13/17 vs. 2/11, P = 0.003; 6/6, vs. 9/22, P = 0.01, respectively). Conclusions. Higher proportion of our patients had FP; preceding BP was a significant risk factor for development of FP and technique failure. Abdominal pain ± fever in patients and catheter in situ were identified as risk factors associated with mortality.",
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N2 - Background. Fungal peritonitis (FP) is a serious complication in patients on continuous ambulatory peritoneal dialysis (CAPD). We reviewed our FP cases to analyse the causative agents and possible risk factors in relation to FP and its outcome and mortality. Methods. Records of all FP cases were reviewed. FP was diagnosed based on effluent cell count and positive fungal culture in suitable media. Results. Between October 1993 and November 2001, 261 patients underwent CAPD. FP was detected in 28 patients, one episode in each patient (14.3% of the total peritonitis episodes). Candida species and dematiaceous fungi ± Candida species were responsible for 89.3 and 10.7% of episodes, respectively. Patients with preceding bacterial peritonitis (BP) developed FP more frequently (25.6%) than de novo cases (2.9%) (P <0.0001) and lower proportion of them continued CAPD (8.6% vs. 60%; P = 0.007). Mortality in patients having abdominal pain with and without fever, and catheter in situ was significantly higher than in those patients who did not have these risk factors (9/11 vs. 6/17, P = 0.01; 13/17 vs. 2/11, P = 0.003; 6/6, vs. 9/22, P = 0.01, respectively). Conclusions. Higher proportion of our patients had FP; preceding BP was a significant risk factor for development of FP and technique failure. Abdominal pain ± fever in patients and catheter in situ were identified as risk factors associated with mortality.

AB - Background. Fungal peritonitis (FP) is a serious complication in patients on continuous ambulatory peritoneal dialysis (CAPD). We reviewed our FP cases to analyse the causative agents and possible risk factors in relation to FP and its outcome and mortality. Methods. Records of all FP cases were reviewed. FP was diagnosed based on effluent cell count and positive fungal culture in suitable media. Results. Between October 1993 and November 2001, 261 patients underwent CAPD. FP was detected in 28 patients, one episode in each patient (14.3% of the total peritonitis episodes). Candida species and dematiaceous fungi ± Candida species were responsible for 89.3 and 10.7% of episodes, respectively. Patients with preceding bacterial peritonitis (BP) developed FP more frequently (25.6%) than de novo cases (2.9%) (P <0.0001) and lower proportion of them continued CAPD (8.6% vs. 60%; P = 0.007). Mortality in patients having abdominal pain with and without fever, and catheter in situ was significantly higher than in those patients who did not have these risk factors (9/11 vs. 6/17, P = 0.01; 13/17 vs. 2/11, P = 0.003; 6/6, vs. 9/22, P = 0.01, respectively). Conclusions. Higher proportion of our patients had FP; preceding BP was a significant risk factor for development of FP and technique failure. Abdominal pain ± fever in patients and catheter in situ were identified as risk factors associated with mortality.

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