OUTCOME OF POLYMICROBIAL PERITONITIS IN CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS PATIENTS

Polymicrobial peritonitis is a relatively uncommon, but potentially se rious complication that develops in continuous ambulatory peritoneal d ialysis (CAPD) patients, Its cause and optimal management remain contr oversial, The authors reviewed the frequency and natural history of po lymicrobial peritonitis in 432 CAPD patients, Of 1,405 episodes of per itonitis, 80 were polymicrobial (6%), Patients with polymicrobial peri tonitis were similar to all CAPD patients in age, gender, race, and un derlying renal disease, Diabetes mellitus, human immunodeficiency viru s (HIV) status, and clinically apparent gastrointestinal disease did n ot predispose patients to polymicrobial peritonitis, Thirty days after the polymicrobial peritonitis, 64 patients remained on CAPD (80%), an d at 180 days 48 patients continued CAPD, Prior exit-site infections w ere present in 12 patients (14%) with polymicrobial peritonitis, Only 22% of patients required catheter removal to treat the infection, We c onclude that polymicrobial peritonitis accounts for 6% of the total ep isodes of peritonitis; diabetes, HIV infection, and underlying gastroi ntestinal disease are not more prevalent in patients with multiorganis m infections, Most patients continue CAPD therapy at 30 and 180 days a fter the episode of polymicrobial peritonitis. (C) 1995 by the Nationa l Kidney Foundation, Inc.