Spontaneous bacterial peritonitis in CAPD patients

Patients with ascites often develop spontaneous bacterial peritonitis (SBP) even if no focus for infection is present. To investigate the frequency of SBP in CAPD patients, we studied the causes of 76 episodes of consecutive peritonitis in 40 patients between 1994 and 1997. SBP was diagnosed if the peritonitis occurred in patients using a sterile connection device without manipulation errors, exit site/skin tunnel infections and cracks in dialysate bags or tubes. Of all 76 peritonitis episodes, 28 (36, 8%) cases were caused from touch contamination and 14 (18.4%) cases were due to exit site/skin tunnel infections, whereas 34 (44.7%) cases were diagnosed as SBP. The most frequently cultured bacteria in SBP were Streptococcus, E. coli and Klebsiella. SBP can not be prevented by improving connection devices and remains an unsolved problem in peritoneal dialysis.