Acinetobacter peritoneal dialysis peritonitis: a changing landscape over time.
Acinetobacter species are assuming an increasingly important role in modern medicine, with their persistent presence in health-care settings and antibiotic resistance. However, clinical reports addressing this issue in patients with peritoneal dialysis (PD) peritonitis are rare.All PD peritonitis ep...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2014-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4196958?pdf=render |
| _version_ | 1818331203005054976 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Chia-Ter Chao |
| collection | DOAJ |
| description | Acinetobacter species are assuming an increasingly important role in modern medicine, with their persistent presence in health-care settings and antibiotic resistance. However, clinical reports addressing this issue in patients with peritoneal dialysis (PD) peritonitis are rare.All PD peritonitis episodes caused by Acinetobacter that occurred between 1985 and 2012 at a single centre were retrospectively reviewed. Clinical features, microbiological data, and outcomes were analysed, with stratifications based upon temporal periods (before and after 2000).Acinetobacter species were responsible for 26 PD peritonitis episodes (3.5% of all episodes) in 25 patients. A. baumannii was the most common pathogen (54%), followed by A. iwoffii (35%), with the former being predominant after 2000. Significantly more episodes resulted from breaks in exchange sterility after 2000, while those from exit site infections decreased (P = 0.01). The interval between the last and current peritonitis episodes lengthened significantly after 2000 (5 vs. 13.6 months; P = 0.05). All the isolates were susceptible to cefepime, fluoroquinolone, and aminoglycosides, with a low ceftazidime resistance rate (16%). Nearly half of the patients (46%) required hospitalisation for their Acinetobacter PD-associated peritonitis, and 27% required an antibiotic switch. The overall outcome was fair, with no mortality and a 12% technique failure rate, without obvious interval differences.The temporal change in the microbiology and origin of Acinetobacter PD-associated peritonitis in our cohort suggested an important evolutional trend. Appropriate measures, including technique re-education and sterility maintenance, should be taken to decrease the Acinetobacter peritonitis incidence in PD patients. |
| first_indexed | 2024-12-13T13:16:07Z |
| format | Article |
| id | doaj.art-2b9d7b58ce3a414ebf7201fbc5e36f1e |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-13T13:16:07Z |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-2b9d7b58ce3a414ebf7201fbc5e36f1e2022-12-21T23:44:31ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-01910e11031510.1371/journal.pone.0110315Acinetobacter peritoneal dialysis peritonitis: a changing landscape over time.Chia-Ter ChaoSzu-Ying LeeWei-Shun YangHuei-Wen ChenCheng-Chung FangChung-Jen YenChih-Kang ChiangKuan-Yu HungJenq-Wen HuangAcinetobacter species are assuming an increasingly important role in modern medicine, with their persistent presence in health-care settings and antibiotic resistance. However, clinical reports addressing this issue in patients with peritoneal dialysis (PD) peritonitis are rare.All PD peritonitis episodes caused by Acinetobacter that occurred between 1985 and 2012 at a single centre were retrospectively reviewed. Clinical features, microbiological data, and outcomes were analysed, with stratifications based upon temporal periods (before and after 2000).Acinetobacter species were responsible for 26 PD peritonitis episodes (3.5% of all episodes) in 25 patients. A. baumannii was the most common pathogen (54%), followed by A. iwoffii (35%), with the former being predominant after 2000. Significantly more episodes resulted from breaks in exchange sterility after 2000, while those from exit site infections decreased (P = 0.01). The interval between the last and current peritonitis episodes lengthened significantly after 2000 (5 vs. 13.6 months; P = 0.05). All the isolates were susceptible to cefepime, fluoroquinolone, and aminoglycosides, with a low ceftazidime resistance rate (16%). Nearly half of the patients (46%) required hospitalisation for their Acinetobacter PD-associated peritonitis, and 27% required an antibiotic switch. The overall outcome was fair, with no mortality and a 12% technique failure rate, without obvious interval differences.The temporal change in the microbiology and origin of Acinetobacter PD-associated peritonitis in our cohort suggested an important evolutional trend. Appropriate measures, including technique re-education and sterility maintenance, should be taken to decrease the Acinetobacter peritonitis incidence in PD patients.http://europepmc.org/articles/PMC4196958?pdf=render |
| spellingShingle | 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 Acinetobacter peritoneal dialysis peritonitis: a changing landscape over time. PLoS ONE |
| title | Acinetobacter peritoneal dialysis peritonitis: a changing landscape over time. |
| title_full | Acinetobacter peritoneal dialysis peritonitis: a changing landscape over time. |
| title_fullStr | Acinetobacter peritoneal dialysis peritonitis: a changing landscape over time. |
| title_full_unstemmed | Acinetobacter peritoneal dialysis peritonitis: a changing landscape over time. |
| title_short | Acinetobacter peritoneal dialysis peritonitis: a changing landscape over time. |
| title_sort | acinetobacter peritoneal dialysis peritonitis a changing landscape over time |
| url | http://europepmc.org/articles/PMC4196958?pdf=render |
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